Stereotactic radiosurgery for bone metastases in oligometastatic prostate cancer patients: DESTROY-2 clinical trial subanalysis

• F. Deodato ^[1] ; D. Pezzulla ^[2] ; S. Cilla ^[1] ; M. Ferro ^[2] ; C. Romano ^[1] ; P. Bonome ^[2] ; M. Buwenge ^[3] ; A. Zamagni ^[4] ; L. Strigari ^[5] ; V. Valentini ^[1] ; A. G. Morganti ^[3] ; G. Macchia ^[2]
  1. [1] Catholic University of the Sacred Heart

     Catholic University of the Sacred Heart

     Milán, Italia

     
  2. [2] Radiation Oncology Unit, Gemelli Molise S.P.A. Hospital, Università Cattolica del S. Cuore, Largo A. Gemelli 1, 86100, Campobasso, Italy
  3. [3] Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy Department of Experimental, Diagnostic, and Specialty Medicine–DIMES, Alma Mater Studiorum Bologna University, Bologna, Italy
  4. [4] Radiotherapy Department, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Via Giuseppe Massarenti, Bologna, Italy
  5. [5] Medical Physics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 24, Nº. 6 (junio), 2022, págs. 1177-1183
• Idioma: inglés
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  • Introduction Aim of this analysis was to report toxicity and clinical outcomes in oligorecurrent prostate cancer (PCa) patients treated with single fraction stereotactic radiosurgery (SRS) for bone metastases.

    Methods We separately analyzed clinical data of PCa patients with bone oligometastases enrolled in a prospective phase I trial (DESTROY-2). DESTROY-2 was based on SRS delivered using volumetric modulated arc therapy in patients with primary or metastatic tumors in several extra-cranial body sites. Acute and late toxicity, biochemical tumor response, local control (LC), distant metastases-free (DPFS), progression-free (PFS), time to next-line systemic treatment-free (NEST-FS), and overall survival (OS) were calculated.

    Results Data on 37 PCa patients, carrying out 50 bone metastases, candidates for curative-intent treatment and treated with SRS at our Institution were collected. SRS dose ranged between 12 and 24 Gy. One grade 1 acute skin toxicity in one patient treated on the hip (24 Gy) and one grade 1 late skin toxicity in a patient with a scapular lesion (24 Gy) were recorded. No cases of bone fracture were registered in the treated population. With a median follow-up of 25 months (range 3–72 months) 2-year actuarial LC, DPFS, PFS, and OS were 96.7%, 58.1%, 58.1%, and 95.8%, respectively. Median and 2-year NEST-FS were 30 months (range 1–69 months) and 51.2%, respectively.

    Conclusions Data analysis showed few toxicity events, high local control rate and prolonged NEST-FS after linear accelerator-based radiosurgery of bone oligometastases from PCa. The possibility of postponing systemic treatments in patients with oligometastatic PCa by means of SRS should be taken into account. Further prospective studies on larger series are needed to confirm the reported results.