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Forschungsdatenbank PMU-SQQUID

Radiotherapy in nodal oligorecurrent prostate cancer.
Pinkawa, M; Aebersold, DM; Bohmer, D; Flentje, M; Ghadjar, P; Schmidt-Hegemann, NS; Hocht, S; Holscher, T; Muller, AC; Niehoff, P; Sedlmayer, F; Wolf, F; Zamboglou, C; Zips, D; Wiegel, T
Strahlenther Onkol. 2021; 197(7):575-580
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PMU-Autor/inn/en

Sedlmayer Felix
Wolf Frank

Abstract

Objective The current article encompasses a literature review and recommendations for radiotherapy in nodal oligorecurrent prostate cancer. Materials and methods 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. Results 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. Conclusion 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.


Useful keywords (using NLM MeSH Indexing)

Humans

Lymph Nodes/pathology

Lymph Nodes/radiation effects

Lymphatic Metastasis/pathology

Lymphatic Metastasis/radiotherapy

Male

Neoplasm Recurrence, Local/pathology

Neoplasm Recurrence, Local/radiotherapy*

Prostatic Neoplasms/pathology

Prostatic Neoplasms/radiotherapy*

Radiosurgery


Find related publications in this database (Keywords)

Prostate cancer
Oligorecurrence
Metastasis-directed therapy
Radiation therapy
Androgen deprivation therapy
Stereotactic body radiotherapy
Oligmometastases
Lymph node metastases