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Stereotactic ablative radiotherapy in castration-resistant prostate cancer patients with oligoprogression during androgen receptor-targeted therapy.

  • Ingrosso, G1
  • Detti, B2
  • Fodor, A3
  • Caini, S4
  • Borghesi, S5
  • Triggiani, L6
  • Trippa, F7
  • Russo, D8
  • Bruni, A9
  • Francolini, G2
  • Lancia, A10
  • Marinelli, L11
  • Di Muzio, N3
  • Livi, L2
  • Magrini, S M6
  • Maranzano, E7
  • Musio, D8
  • Aristei, C12
  • Valeriani, M11
  • 1 Radiation Oncology Section, Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy. [email protected] , (Italy)
  • 2 Department of Radiation Oncology, A.O.U Careggi, University of Florence, Florence, Italy. , (Italy)
  • 3 Department of Radiation Oncology, San Raffaele Scientific Institute, Milan, Italy. , (Italy)
  • 4 Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Networking, Florence, Italy. , (Italy)
  • 5 Unit of Radiation Oncology, S. Donato Hospital, Arezzo, Italy. , (Italy)
  • 6 Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy. , (Italy)
  • 7 Department of Radiation Oncology, 'S. Maria' Hospital, Terni, Italy. , (Italy)
  • 8 Radiotherapy Unit, Ospedale "Vito Fazzi", Lecce, Italy. , (Italy)
  • 9 Radiotherapy Unit, University Hospital of Modena, Modena, Italy. , (Italy)
  • 10 Department of Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. , (Italy)
  • 11 Department of Medicine and Surgery and Translational Medicine, "Sapienza" University of Rome, Radiotherapy Oncology Operative Unit, St Andrea Hospital, Rome, Italy. , (Italy)
  • 12 Radiation Oncology Section, Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy. , (Italy)
Published Article
Clinical & Translational Oncology
Publication Date
Aug 01, 2021
DOI: 10.1007/s12094-021-02553-5
PMID: 33495981


To report outcomes of stereotactic body radiotherapy (SBRT) in metastatic castration-resistant prostate cancer (mCRPC) patients with oligoprogression (≤ 5 metastases) during first-line treatment with androgen receptor-targeted therapy (ARTT). Retrospective multi-institutional analysis of mCRPC patients treated with SBRT to oligoprogressive lesions during ARTT. End-points were time to next-line systemic treatment (NEST), radiological progression-free survival (r-PFS) and overall survival (OS). Toxicity was registered according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0. Survival analysis was performed using the Kaplan-Meier method, univariate and multivariate analysis (MVA) were performed. Data from 34 patients were analyzed. Median NEST-free survival, r-PFS, and OS were 16.97, 13.47, and 38.3 months, respectively. At MVA, factors associated with worse NEST-free survival and r-PFS were polymetastatic burden at diagnosis of metastatic hormone-sensitive disease (hazard ratio [HR] 3.66, p = 0.009; HR 3.03, p = 0.034), PSA ≤ 7 ng/ml at mCRPC diagnosis (HR 0.23, p = 0.017; HR 0.19, p = 0.006) and PSADT ≤ 3 months at mCRPC diagnosis (HR 3.39, p = 0.026; HR 2.79, p = 0.037). Polymetastatic state at mHSPC diagnosis was associated with a decreased OS (HR 4.68, p = 0.029). No patient developed acute or late grade ≥ 2 toxicity. Our results suggest that SBRT in oligoprogressive mCPRC is safe, effective and seems to prolong the efficacy of the ongoing systemic treatment positively affecting disease progression. Prospective trials are needed.

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