Long-Term Outcomes of Patients on a Phase II Prospective Trial of Oligometastatic Hormone-Sensitive Prostate Cancer Treated with Androgen Deprivation and External Beam Radiation.

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International journal of radiation oncology, biology, physics


california; jwci; sjci


PURPOSE: External beam radiation therapy (EBRT) to oligometastases may improve outcomes in patients with oligometastatic hormone-sensitive prostate cancer (oHSPC). Follow-up on this cohort has been limited to(ADT) on a prospective trial.

MATERIALS AND METHODS: From 2006 to 2011, oHSPC patients with 1-5 metastases (mts) received 36 weeks of ADT (LHRH agonist + bicalutamide) and up to 53 Gy to all visible mts. When indicated, the primary tumor or prostate bed was treated with EBRT up to 78 Gy or 66 Gy, respectively.

RESULTS: 29 patients were treated: 15 de novo, 14 oligorecurrent. 21 patients (72.4%) had bone mts. Median number of mts per patient was 1 (range 1-5). EBRT was administered to 52 lesions (38 bone, 12 pelvic lymph nodes [LNs], 2 non-pelvic LNs) up to 53 Gy (range 47-66). Median follow-up was 9.9 years (yrs, range 0.2-14.4). Median overall survival (OS) was 9.7 yrs (95% Confidence Interval [CI]:5.8-Not Reached [NR]). Median progression-free survival (PFS) was 1.9 yrs (95%CI: 1.6-2.2). Patients who presented with prostate cancer-defined de novo mts had significantly improved (p=0.04) median PFS (2.0 yrs, 95%CI: 1.3-6.0) compared to oligorecurrent pts (1.8 yrs, 95%CI: 1.0-2.0). Patients who presented with LN-only mts had numerically improved (p=0.13) median PFS (5.8 yrs, 95%CI: 1.2-NR) compared to patients with bony mts (1.8 yrs, 95%CI: 1.3-2.0). At last follow-up, 17 patients (58.6%) had local control of all EBRT treated mts. The mts that locally progressed had previously been controlled for median 3.5 yrs (range 1.7-10.5).

CONCLUSION: Our results compare favorably with other reported studies of oHSPC and provide new insights into their long-term outcomes.

Clinical Institute