Journal article
Radiotherapy treatment volumes for oligorecurrent nodal prostate cancer: a systematic review.
- Achard V Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland.
- Bottero M Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland.
- Rouzaud M Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland.
- Lancia A Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
- Scorsetti M Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Milan, Italy.
- Filippi AR Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
- Franzese C Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Milan, Italy.
- Jereczek-Fossa BA Division of Radiotherapy, IEO European Institute of oncology, IRCCS, Milan, Italy.
- Ingrosso G Radiation Oncology section, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia General Hospital, Perugia, Italy.
- Ost P Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium.
- Zilli T Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland.
- 2020-06-16
Published in:
- Acta oncologica (Stockholm, Sweden). - 2020
English
BACKGROUND
Radiotherapy is an emerging treatment strategy for nodal oligorecurrent prostate cancer (PCa) patients. However, large heterogeneities exist in the RT regimens used, with series reporting the use of elective nodal radiotherapy (ENRT) strategies and others the delivery of focal treatments to the relapsing nodes with Stereotactic Body Radiotherapy (SBRT). In this systematic review of the literature we compared the oncological outcomes and toxicity of the different RT regimens for nodal oligorecurrent PCa patients, with the aim of defining the optimal RT target volume in this setting.
METHODS
We performed a systemic search on the Pubmed database to identify articles reporting on the use of ENRT or SBRT for oligometastatic PCa with nodal recurrence.
RESULTS
Twenty-two articles were analyzed, including four prospective phase II trials (3 with SBRT and 1 with ENRT). Focal SBRT, delivered with an involved node, involved site, and involved field modality, was the most commonly used strategy with 2-year progression-free survival (PFS) rates ranging from 16 to 58% and a very low toxicity profile. Improved PFS rates were observed with ENRT strategies (52-80% at 3 years) compared to focal SBRT, despite a slightly higher toxicity rate. One ongoing randomized phase II trial is comparing both modalities in patients with nodal oligorecurrent PCa.
CONCLUSIONS
With a large variability in patterns of practice, the optimal RT strategy remains to be determined in the setting of nodal oligorecurrent PCa. Ongoing randomized trials and advances in translational research will help to shed light on the best management for these patients. .
Radiotherapy is an emerging treatment strategy for nodal oligorecurrent prostate cancer (PCa) patients. However, large heterogeneities exist in the RT regimens used, with series reporting the use of elective nodal radiotherapy (ENRT) strategies and others the delivery of focal treatments to the relapsing nodes with Stereotactic Body Radiotherapy (SBRT). In this systematic review of the literature we compared the oncological outcomes and toxicity of the different RT regimens for nodal oligorecurrent PCa patients, with the aim of defining the optimal RT target volume in this setting.
METHODS
We performed a systemic search on the Pubmed database to identify articles reporting on the use of ENRT or SBRT for oligometastatic PCa with nodal recurrence.
RESULTS
Twenty-two articles were analyzed, including four prospective phase II trials (3 with SBRT and 1 with ENRT). Focal SBRT, delivered with an involved node, involved site, and involved field modality, was the most commonly used strategy with 2-year progression-free survival (PFS) rates ranging from 16 to 58% and a very low toxicity profile. Improved PFS rates were observed with ENRT strategies (52-80% at 3 years) compared to focal SBRT, despite a slightly higher toxicity rate. One ongoing randomized phase II trial is comparing both modalities in patients with nodal oligorecurrent PCa.
CONCLUSIONS
With a large variability in patterns of practice, the optimal RT strategy remains to be determined in the setting of nodal oligorecurrent PCa. Ongoing randomized trials and advances in translational research will help to shed light on the best management for these patients. .
- Language
-
- English
- Open access status
- closed
- Identifiers
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- DOI 10.1080/0284186X.2020.1775291
- PMID 32536241
- Persistent URL
- https://sonar.ch/global/documents/46802
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