TY - JOUR
T1 - Radiotherapy as metastasis-directed therapy for oligometastatic prostate cancer
AU - De Bleser, Elise
AU - Tran, Phuoc T.
AU - Ost, Piet
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Purpose of review To summarize the available literature regarding radiotherapy as a metastasis-directed therapy (MDT) in the treatment of oligometastatic prostate cancer (PCA). Recent findings Three different clinical scenarios of oligometastatic PCA exist in which MDT can be applied: de novo oligometastatic PCA, oligorecurrent PCA, and oligoprogressive PCA. A cut off of three to five metastatic lesions is most often used in these settings. Data from retrospective studies, treating over 1000 patients in total, have been reported. The median progression-free survival ranges between 1 and 3 years, but is influenced by a heterogeneous use of androgen deprivation therapy. For lymph node metastases, a propensity scored matched analysis suggests that cancer specific and overall survival is improved with MDT over standard of care. MDT treatment regimens vary with different radiotherapy techniques, doses, and volumes. Adverse events are limited to grade 1-2 and only rarely grade 3 events are reported. Summary Based on data from retrospective studies, progression-free survival following MDT for oligometastatic PCA is promising with few adverse events. Comparative prospective studies are under way and will shed light on the future of MDT.
AB - Purpose of review To summarize the available literature regarding radiotherapy as a metastasis-directed therapy (MDT) in the treatment of oligometastatic prostate cancer (PCA). Recent findings Three different clinical scenarios of oligometastatic PCA exist in which MDT can be applied: de novo oligometastatic PCA, oligorecurrent PCA, and oligoprogressive PCA. A cut off of three to five metastatic lesions is most often used in these settings. Data from retrospective studies, treating over 1000 patients in total, have been reported. The median progression-free survival ranges between 1 and 3 years, but is influenced by a heterogeneous use of androgen deprivation therapy. For lymph node metastases, a propensity scored matched analysis suggests that cancer specific and overall survival is improved with MDT over standard of care. MDT treatment regimens vary with different radiotherapy techniques, doses, and volumes. Adverse events are limited to grade 1-2 and only rarely grade 3 events are reported. Summary Based on data from retrospective studies, progression-free survival following MDT for oligometastatic PCA is promising with few adverse events. Comparative prospective studies are under way and will shed light on the future of MDT.
KW - oligometastases
KW - prostate cancer
KW - stereotactic body radiotherapy
KW - whole pelvis radiotherapy
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U2 - 10.1097/MOU.0000000000000441
DO - 10.1097/MOU.0000000000000441
M3 - Review article
C2 - 28816714
AN - SCOPUS:85030775222
SN - 0963-0643
VL - 27
SP - 587
EP - 595
JO - Current Opinion in Urology
JF - Current Opinion in Urology
IS - 6
ER -