Spatial Distribution of Recurrence and Long-Term Toxicity Following Dose Escalation to the Dominant Intra-Prostatic Nodule for Intermediate-High-Risk Prostate Cancer: Insights from a Phase I/II Study.

Details

Ressource 1Request a copy Under indefinite embargo.
UNIL restricted access
State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_F69D11E34A2A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Spatial Distribution of Recurrence and Long-Term Toxicity Following Dose Escalation to the Dominant Intra-Prostatic Nodule for Intermediate-High-Risk Prostate Cancer: Insights from a Phase I/II Study.
Journal
Cancers
Author(s)
Cloître M., Benkhaled S., Boughdad S., Schaefer N., Prior J.O., Zeverino M., Berthold D., Tawadros T., Meuwly J.Y., Martel P., Rohner C., Heym L., Duclos F., Vallet V., Valerio M., Bourhis J., Herrera F.
ISSN
2072-6694 (Print)
ISSN-L
2072-6694
Publication state
Published
Issued date
31/05/2024
Peer-reviewed
Oui
Volume
16
Number
11
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Objectives: We investigated spatial patterns between primary and recurrent tumor sites and assessed long-term toxicity after dose escalation stereotactic body radiation therapy (SBRT) to the dominant intra-prostatic nodule (DIN). Materials and methods: In 33 patients with intermediate-high-risk prostate cancer (PCa), doses up to 50 Gy were administered to the DIN. Recurrence sites were determined and compared to the original tumor development sites through multiparametric MRI and <sup>68</sup> Ga-labeled prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography ( <sup>68</sup> Ga-PSMA-PET/CT) images. Overlap rates, categorized as 75% or higher for full overlap, and 25-74% for partial overlap, were assessed. Long-term toxicity is reported. Results: All patients completed treatment, with only one receiving concomitant androgen deprivation therapy (ADT). Recurrences were diagnosed after a median of 33 months (range: 17-76 months), affecting 13 out of 33 patients (39.4%). Intra-prostatic recurrences occurred in 7 patients (21%), with ≥75% overlap in two, a partial overlap in another two, and no overlap in the remaining three patients. Notably, five patients with intra-prostatic recurrences had synchronous bone and/or lymph node metastases, while six patients had isolated bone or lymph node metastasis without intra-prostatic recurrences. Extended follow-up revealed late grade ≥ 2 GU and GI toxicity in 18% (n = 6) and 6% (n = 2) of the patients. Conclusions: Among patients with intermediate-high-risk PCa undergoing focal dose-escalated SBRT without ADT, DIN recurrences were infrequent. When present, these recurrences were typically located at the original site or adjacent to the initial tumor. Conversely, relapses beyond the DIN and in extra-prostatic (metastatic) sites were prevalent, underscoring the significance of systemic ADT in managing this patient population. Advances in knowledge: Focal dose-escalated prostate SBRT prevented recurrences in the dominant nodule; however, extra-prostatic recurrence sites were frequent.
Keywords
Sbrt, dosimetry analysis, intermediate–high-risk, pattern of recurrence, prostate cancer, stereotactic treatment, SBRT
Pubmed
Web of science
Open Access
Yes
Create date
21/06/2024 10:07
Last modification date
02/07/2024 8:37
Usage data