TITLE:
Radiotherapy of Oligoprogressive Lesions in Castration-Resistant Prostate Cancer: Impact on Second-Generation Hormone Therapy
AUTHORS:
Kanta Ka, Papa Macoumba Gaye, Awa Sadikh Badiane, Ibrahima Thiam, Mouhamadou Bachir Ba, Papa Massamba Diene, Maimouna Mané, Lamine Niang, Fatou Samba Ndiaye
KEYWORDS:
Ablative Radiotherapy, Hormone Therapy, Oligometastasis, Prostate, Castration-Resistant Cancer
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.12 No.5,
May
31,
2021
ABSTRACT: Background: The therapeutic standard for oligoprogressive prostate cancer resistant
to castration is second-generation hormone therapy. This systemic treatment is
expensive. There are oligoprogressive lesions accessible to radiotherapy. Objectives: To study the impact of radiotherapy of oligoprogressive lesions on the implementation of second generation hormone therapy. Patients and Methods: A retrospective study from 2012 to 2020 was
carried out. All patients with oligoprogressive prostate cancer who had
received radiotherapy on one or more lesions in progression were collated.
Survival was calculated using the Kaplan-Meier method. Results: 8
patients were treated with stereotactic and conformational radiotherapy between
August 2012 and August 2020 in the context of oligoprogressive prostate cancer
resistant to castration. The median age at diagnosis of oligoprogression was 73
years with a median PSA level of 3.11 ng/ml. Nine lesions were diagnosed with
PET scan PSMA. All the lesions were treated by radiotherapy with different
regimens. After a median follow-up of 12.5 months, 7 patients showed a
biochemical response to treatment with a median decrease in PSA of 67%. The
median survival without clinical or biochemical progression was 7 months. The
median survival without the need for further systemic treatment was 9 months.
During the follow-up period, six patients received second-generation hormone
therapy to treat their relapse, and the other two showed no clinical or
biochemical relapse. Conclusion: Radiotherapy may be an alternative to
delay the introduction of difficult-to-access second-generation hormone therapy
in developing countries. A prospective study could validate this therapeutic
approach.