Radiotherapy for the treatment of distant nodes metastases from oligometastatic urothelial cancer: A retrospective case series.

Objectives: To investigate the efficacy of stereotactic body radiotherapy in oligometastatic urothelial carcinoma with node-only involvement.

Methods: We retrospectively collected data on the outcomes of patients who underwent stereotactic body radiotherapy for metastatic node lesions from oligometastatic urothelial carcinoma at Radiotherapy Unit of University Hospital of Parma, Parma, Italy. The investigated outcomes were lesion size, standardized uptake value, overall response rate, lesion control rate, lesion progression-free interval, progression-free survival and overall survival.

Results: Among seven patients included in the study, a total of 14 node metastatic lesions were treated with stereotactic body radiotherapy. The mean total dose of stereotactic body radiotherapy was 32 Gy (range 25-40 Gy). At first imaging evaluation, a mean variation of -4% (P = 0.427) in major diameter, -16% (P = 0.048) in minor diameter and -76% in standardized uptake value (P < 0.001) were documented. The overall response rate and lesion control rate were 43% and 100%, respectively. Median lesion progression-free interval, progression-free survival and overall survival were 11.4 months (95% CI 3.4-19.4), 2.9 months (95% CI 2.6-3.1) and 14.9 months (95% CI 12.3-17.5), respectively. Stereotactic body radiotherapy was effective in delaying the beginning of a systemic chemotherapy in four patients.

Conclusions: The present findings generate the hypothesis of a possible role for the use of stereotactic body radiotherapy in selected patients with distant node metastases from oligometastatic urothelial carcinoma.