Radiotherapy in nodal oligorecurrent prostate cancer.
Androgen deprivation therapy
Lymph node metastases
Metastasis-directed therapy
Oligmometastases
Oligorecurrence
Prostate cancer
Radiation therapy
Stereotactic body radiotherapy
Journal
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
ISSN: 1439-099X
Titre abrégé: Strahlenther Onkol
Pays: Germany
ID NLM: 8603469
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
17
03
2021
accepted:
23
03
2021
pubmed:
30
4
2021
medline:
2
9
2021
entrez:
29
4
2021
Statut:
ppublish
Résumé
The current article encompasses a literature review and recommendations for radiotherapy in nodal oligorecurrent prostate cancer. A literature review focused on studies comparing metastasis-directed stereotactic ablative radiotherapy (SABR) vs. external elective nodal radiotherapy (ENRT) and studies analyzing recurrence patterns after local nodal treatment was performed. The DEGRO Prostate Cancer Expert Panel discussed the results and developed treatment recommendations. Metastasis-directed radiotherapy results in high local control (often > 90% within a follow-up of 1-2 years) and can be used to improve progression-free survival or defer androgen deprivation therapy (ADT) according to prospective randomized phase II data. Distant progression after involved-node SABR only occurs within a few months in the majority of patients. ENRT improves metastases-free survival rates with increased toxicity in comparison to SABR according to retrospective comparative studies. The majority of nodal recurrences after initial local treatment of pelvic nodal metastasis are detected within the true pelvis and common iliac vessels. ENRT with or without a boost should be preferred to SABR in pelvic nodal recurrences. In oligometastatic prostate cancer with distant (extrapelvic) nodal recurrences, SABR alone can be performed in selected cases. Application of additional systemic treatments should be based on current guidelines, with ADT as first-line treatment for hormone-sensitive prostate cancer. Only in carefully selected patients can radiotherapy be initially used without additional ADT outside of the current standard recommendations. Results of (randomized) prospective studies are needed for definitive recommendations.
Identifiants
pubmed: 33914101
doi: 10.1007/s00066-021-01778-1
pii: 10.1007/s00066-021-01778-1
pmc: PMC8219546
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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