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02.07.2020 | Original Article

Treatment outcomes of metastasis-directed treatment using ⁶⁸Ga-PSMA-PET/CT for oligometastatic or oligorecurrent prostate cancer: Turkish Society for Radiation Oncology group study (TROD 09-002)

verfasst von: Pervin Hurmuz, M.D., Cem Onal, M.D., Gokhan Ozyigit, M.D., Sefik Igdem, M.D., Banu Atalar, M.D., Haluk Sayan, M.D., Zuleyha Akgun, M.D., Meral Kurt, M.D., Hale Basak Ozkok, M.D., Ugur Selek, M.D., Ezgi Oymak, M.D., Burak Tilki, M.D., Ozan Cem Guler, M.D., Teuto Zoto Mustafayev, M.D., Ph.D., Irem Saricanbaz, M.D., Rashad Rzazade, M.D., Fadıl Akyol, M.D.

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 11/2020

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Abstract

Purpose

The aim of this study was to evaluate the outcomes of ⁶⁸Ga prostate-specific membrane antigen (⁶⁸Ga-PSMA) positron-emission tomography (PET)/CT-based metastasis-directed treatment (MDT) for oligometastatic prostate cancer (PC).

Methods

In this multi-institutional study, clinical data of 176 PC patients with 353 lesions receiving MDT between 2014 and 2019 were retrospectively evaluated. All patients had biopsy proven PC with ≤5 metastases detected with ⁶⁸Ga-PSMA-PET/CT. MDT was delivered with conventional fractionation or stereotactic body radiotherapy (SBRT) techniques. CTCAE v4.0 was used for acute and RTOG/EORTC Late Radiation Morbidity Scoring Schema was used for late toxicity evaluation.

Results

At the time of MDT, 59 patients (33.5%) had synchronous and 117 patients (66.5%) had metachronous metastases. Median number of metastases was one and the MDT technique was SBRT in 73.3% patients. The 2‑year overall survival (OS) and progression-free survival (PFS) rates were 87.6% and 63.1%, respectively. With a median follow-up of 22.9 months, 9 patients had local recurrence at the irradiated site. The 2‑year local control rate at the treated oligometastatic site per patient was 93.2%. In multivariate analysis, an increased number of oligometastases and untreated primary PC were negative predictors for OS; advanced clinical tumor stage, untreated primary PC, BED3 value of ≤108 Gy, and MDT with conventional fractionation were negative predictors for PFS. No patient experienced grade ≥3 acute toxicity, but one patient had a late grade 3 toxicity of compression fracture after spinal SBRT.

Conclusion

⁶⁸Ga-PSMA-PET/CT-based MDT is an efficient and safe treatment for oligometastatic PC patients. Proper patient selection might improve treatment outcomes.

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Titel: Treatment outcomes of metastasis-directed treatment using 68Ga-PSMA-PET/CT for oligometastatic or oligorecurrent prostate cancer: Turkish Society for Radiation Oncology group study (TROD 09-002)
verfasst von: Pervin Hurmuz, M.D.
Cem Onal, M.D.
Gokhan Ozyigit, M.D.
Sefik Igdem, M.D.
Banu Atalar, M.D.
Haluk Sayan, M.D.
Zuleyha Akgun, M.D.
Meral Kurt, M.D.
Hale Basak Ozkok, M.D.
Ugur Selek, M.D.
Ezgi Oymak, M.D.
Burak Tilki, M.D.
Ozan Cem Guler, M.D.
Teuto Zoto Mustafayev, M.D., Ph.D.
Irem Saricanbaz, M.D.
Rashad Rzazade, M.D.
Fadıl Akyol, M.D.
Publikationsdatum: 02.07.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 11/2020
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-020-01660-6

Springer Medizin

Treatment outcomes of metastasis-directed treatment using ⁶⁸Ga-PSMA-PET/CT for oligometastatic or oligorecurrent prostate cancer: Turkish Society for Radiation Oncology group study (TROD 09-002)