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30.01.2019 | Original Article

Outcome of loco-regional radiotherapy in metastatic castration-resistant prostate cancer patients treated with abiraterone acetate

verfasst von: Berna Akkus Yildirim, MD, Cem Onal, MD, Fatih Kose, MD, Ezgi Oymak, MD, Ali Murat Sedef, MD, Ali Ayberk Besen, MD, Sercan Aksoy, MD, Ozan Cem Guler, MD, Ahmet Taner Sumbul, MD, Sadık Muallaoglu, MD, Huseyin Mertsoylu, MD, Gokhan Ozyigit, MD

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 10/2019

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Abstract

Purpose

To evaluate the potential benefit of curative radiotherapy (RT) to the primary tumor in metastatic castration-resistant prostate cancer (mCRPC) patients treated with abiraterone.

Materials and methods

The clinical parameters of 106 mCRPC patients treated with abiraterone were retrospectively evaluated. Patients were either oligometastatic (≤5 metastases) at diagnosis or became oligometastatic after the systemic treatment was analyzed. Local RT to the primary tumor and pelvic lymphatics was delivered in 44 patients (41%), and 62 patients (59%) did not have RT to the primary tumor. After propensity match analysis, a total of 92 patients were analyzed.

Resultsn

Median follow-up time was 14.2 months (range: 2.3–54.9 months). Median overall survival (OS) was higher in patients treated with local RT to the primary tumor than in those treated without local RT with borderline significance (24.1 vs. 21.4 months; p = 0.08). Local RT to the prostate and pelvic lymphatics significantly diminished the local recurrence rate (16 patients, 31% vs. 2 patients, 5%; p = 0.003). In multivariate analysis, the prostate specific antigen (PSA) response ≥50% of the baseline obtained 3 weeks after abiraterone therapy was the only significant prognostic factor for better OS and progression-free survival (PFS). Patients treated with primary RT to the prostate had significantly less progression under abiraterone and a longer abiraterone period than those treated without local prostate RT.

Conclusions

Local prostate RT significantly improved OS and local control in mCRPC patients treated with abiraterone. The patients treated with primary RT had significantly less progression under abiraterone and a longer abiraterone period than those treated without local prostate RT.

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Titel: Outcome of loco-regional radiotherapy in metastatic castration-resistant prostate cancer patients treated with abiraterone acetate
verfasst von: Berna Akkus Yildirim, MD
Cem Onal, MD
Fatih Kose, MD
Ezgi Oymak, MD
Ali Murat Sedef, MD
Ali Ayberk Besen, MD
Sercan Aksoy, MD
Ozan Cem Guler, MD
Ahmet Taner Sumbul, MD
Sadık Muallaoglu, MD
Huseyin Mertsoylu, MD
Gokhan Ozyigit, MD
Publikationsdatum: 30.01.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 10/2019
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-019-01429-6

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Outcome of loco-regional radiotherapy in metastatic castration-resistant prostate cancer patients treated with abiraterone acetate