SBRT delays treatment escalation in oligometastatic prostate cancer

  • Bowden P & al.
  • Int J Cancer
  • 14 Jun 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Stereotactic body radiotherapy (SBRT) delays treatment escalation in men with oligometastatic prostate cancer regardless of the number of lesions.
  • No associated grade 3 toxicity was observed.

Why this matters

  • Findings suggest SBRT can delay treatment escalation and improve QoL in selected patients. 

Study design

  • Interim analysis of phase 2 TRANSFORM study of 199 men with prostate cancer (≤5 lesions) previously treated with definitive local treatment who received fractionated SBRT.
  • Funding: Epworth Medical Foundation; E.J. Whitten Prostate Cancer Foundation.

Key results

  • Median follow-up time, 35.1 months.
  • 51.7% of patients did not require treatment escalation at 2 years.
  • Median treatment escalation-free survival time was 27.1 months.
  • Rising PSA and progression were the most common reasons for treatment escalation.
  • Prior androgen deprivation therapy use (HR, 1.97; P=.005) and increasing age (HR, 1.39; P<.001 were associated with treatment escalation.>
  • Treatment escalation was similar in patients with 1-3 vs 4-5 lesions.
  • 75.0% of patients showed PSA decline after SBRT, and 6 had undetectable PSA level.
  • No late grade 3 toxicities were reported.

Limitations

  • Lack of a control group.