title: Stereotactic body radiotherapy in oligometastatic prostate cancer patients with isolated lymph nodes involvement: a two-institution experience.
abstract: OBJECTIVE
  Stereotactic body radiotherapy (SBRT) is emerging as a treatment option in oligometastatic cancer patients. This retrospective study aimed to analyze local control, biochemical progression-free survival (b-PFS), and toxicity in patients affected by isolated prostate cancer lymph node metastases. Finally, we evaluated androgen deprivation therapy-free survival (ADT-FS).
  
  
  METHODS
  Forty patients with 47 isolated lymph nodes of recurrent prostate cancer were treated with SBRT. Mostly, two different fractionation schemes were used: 5 × 7 Gy in 23 (48.9 %) lesions and 5 × 8 Gy in 13 (27.7 %) lesions. Response to treatment was assessed with periodical PSA evaluation. Toxicity was registered according to RTOG/EORTC criteria.
  
  
  RESULTS
  With a mean follow-up of 30.18 months, local control was achieved in 98 % of the cases, with a median b-PFS of 24 months. We obtained a 2-year b-PFS of 44 % with 40 % of the patients ADT-free at last follow-up (mean value 26.18 months; range 3.96-59.46), whereas 12.5 % had a mean ADT-FS of 13.58 months (range 2.06-37.13). Late toxicity was observed in one (2.5 %) patient who manifested a grade 3 gastrointestinal toxicity 11.76 months after the end of SBRT.
  
  
  CONCLUSIONS
  Our study demonstrates that SBRT is safe, effective, and minimally invasive in the eradication of limited nodal metastases, yielding an important delay in prescribing ADT.
authors.affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Tor Vergata General Hospital, viale Oxford 81, 00133, Rome, Italy. ingrosso.gianluca@gmail.com.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Ingrosso
authors.affiliation: Department of Oncology, Radiation Oncology Center, "S. Maria" Hospital, Terni, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Trippa
authors.affiliation: Department of Oncology, Radiation Oncology Center, "S. Maria" Hospital, Terni, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Maranzano
authors.affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Tor Vergata General Hospital, viale Oxford 81, 00133, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Carosi
authors.affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Tor Vergata General Hospital, viale Oxford 81, 00133, Rome, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Ponti
authors.affiliation: Department of Oncology, Radiation Oncology Center, "S. Maria" Hospital, Terni, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Arcidiacono
authors.affiliation: Department of Oncology, Radiation Oncology Center, "S. Maria" Hospital, Terni, Italy.
authors.forename: Lorena
authors.initials: L
authors.lastname: Draghini
authors.affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Tor Vergata General Hospital, viale Oxford 81, 00133, Rome, Italy.
authors.forename: Luana
authors.initials: L
authors.lastname: Di Murro
authors.affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Tor Vergata General Hospital, viale Oxford 81, 00133, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lancia
authors.affiliation: Department of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy, Tor Vergata General Hospital, viale Oxford 81, 00133, Rome, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Santoni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use; D018572:Disease-Free Survival; D006801:Humans; D007610:Kallikreins / Q000097:blood; D008198:Lymph Nodes / Q000473:pathology / Q000528:radiation effects; D008207:Lymphatic Metastasis; D008297:Male; D059146:Metastasectomy / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000473:pathology / Q000532:radiotherapy*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000532:radiotherapy*; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D000726:Androgen Antagonists; C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Androgen deprivation therapy-free survival; Local control; Oligometastasis; Prostate cancer; Stereotactic body radiotherapy