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. 2021 Mar 9;16(1):50.
doi: 10.1186/s13014-021-01776-8.

Radiotherapy of oligometastatic prostate cancer: a systematic review

Paul Rogowski  1 , Mack Roach 3rd  2 , Nina-Sophie Schmidt-Hegemann  3 , Christian Trapp  3 , Rieke von Bestenbostel  3 , Run Shi  3 , Alexander Buchner  4 , Christian Stief  4 , Claus Belka  3   5 , Minglun Li  3
Affiliations

Radiotherapy of oligometastatic prostate cancer: a systematic review

Paul Rogowski et al. Radiat Oncol. .

Abstract

Background: Due to improved imaging sensitivity, the term "oligometastatic" prostate cancer disease is diagnosed more often, leading to an increasing interest in metastasis-directed therapy (MDT). There are two types of radiation based MDT applied when treating oligometastatic disease: (1) stereotactic body radiation therapy (SBRT) generally used for bone metastases; or (2) SBRT for isolated nodal oligometastases combined with prophylactic elective nodal radiotherapy. This review aims to summarize current evidence data, which may shed light on the optimal management of this heterogeneous group of patients.

Methods: A systematic review of the Medline database through PubMed was performed according to PRISMA guidelines. All relevant studies published up to November 2020 were identified and screened. Fifty-six titles were included. Besides outcome parameters, different prognostic and predictive factors were assessed, including site of metastases, time between primary treatment and MDT, use of systemic therapies, hormone sensitivity, as well as pattern of recurrence.

Findings: Evidence consists largely of retrospective case series and no consistent precise definition of oligometastasis exists, however, most investigators seem to acknowledge the need to distinguish between patients presenting with what is frequently called "synchronous" versus "metachronous" oligometastatic disease. Available data on radiotherapy as MDT demonstrate high local control rates and a small but relevant proportion of patients without progressive disease after 2 years. This holds true for both hormone sensitive and castration resistant prostate cancer diseases. The use of 68Ga-PSMA PET/CT for staging increased dramatically. Radiation doses and field sizes varied considerably among the studies. The search for relevant prognostic and predictive factors is ongoing.

Conclusions: To our best knowledge this review on oligometastatic prostate cancer included the largest number of original articles. It demonstrates the therapeutic potential and challenges of MDT for oligometastatic prostate cancer. Prospective studies are under way and will provide further high-level evidence.

Keywords: ENRT; Metastasis‐directed therapy; Oligometastatic prostate cancer; Radiotherapy; SBRT.

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Conflict of interest statement

CB reports a research grant from ViewRay and speakers honoraria from Takeda during the conduct of the study.

Figures

Fig. 1
Fig. 1
Publications on oligometastatic prostate cancer
Fig. 2
Fig. 2
Selection process
See this image and copyright information in PMC

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424. doi: 10.3322/caac.21492. - DOI - PubMed
    1. Cornford P, Bellmunt J, Bolla M, Briers E, De Santis M, Gross T, et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part II: treatment of relapsing, metastatic, and castration-resistant prostate cancer. Eur Urol. 2017;71(4):630–642. doi: 10.1016/j.eururo.2016.08.002. - DOI - PubMed
    1. Hellman, Weichselbaum. Oligometastases. 1995. - PubMed
    1. Fossati N, Suardi N, Gandaglia G, Bravi CA, Soligo M, Karnes RJ, et al. Identifying the optimal candidate for salvage lymph node dissection for nodal recurrence of prostate cancer: results from a large, multi-institutional analysis. Eur Urol. 2019;75(1):176–183. doi: 10.1016/j.eururo.2018.09.009. - DOI - PMC - PubMed
    1. Gillessen S, Attard G, Beer TM, Beltran H, Bossi A, Bristow R, et al. Management of patients with advanced prostate cancer: the report of the advanced prostate cancer consensus conference APCCC 2017 [figure presented] Eur Urol. 2018;73(2):178–211. doi: 10.1016/j.eururo.2017.06.002. - DOI - PubMed

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