Oligometastatic prostate cancer is an evolving clinical entity as more data from novel imaging tools such as PSMA PET/CT emerges. Recognition of this disease entity allows for unique interventions which differ from conventional treatment of metastatic prostate cancers such as the initiation of chemotherapy. With metastasis-directed therapy (MDT), there is potential for early eradication of limited disease metastases and a delay in systemic treatment with its associated treatment-related toxicities. This review explores the current evidence and outcomes of different metastasis-directed therapies such as the role of radiotherapy in low volume metastasis and the use of PSMA ligands to facilitate pelvic lymph node dissections. With a deeper understanding of this low metastasis state, it has revolutionized the current viable treatment options, and more studies are ongoing to provide further insights into this unique disease entity.
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http://dx.doi.org/10.3390/jcm12237198 | DOI Listing |
Cancer Med
December 2024
Department of Urology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Objective: We aimed to develop and validate a nomogram based on MRI radiomics to predict overall survival (OS) for patients with de novo oligometastatic prostate cancer (PCa).
Methods: A total of 165 patients with de novo oligometastatic PCa were included in the study (training cohort, n = 115; validating cohort, n = 50). Among them, MRI scans were conducted and T2-weighted imaging (T2WI) and apparent diffusion coefficient (ADC) sequences were collected for radiomics features along with their clinicopathological features.
Int J Radiat Oncol Biol Phys
December 2024
Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Purpose: This study reports on the clinical outcomes of the single arm phase-II STEAL trial investigating online adaptive stereotactic body radiotherapy (SBRT) for abdominal-pelvic lymph node (A-P LN) oligometastases.
Methods: Patients with oligometastatic A-P LN were enrolled and treated to a total dose of 45 Gy in five fractions on the CyberKnife. For each patient, a library of three plans was created using a pre-treatment diagnostic CT scan and the treatment planning CT scan.
Radiat Oncol
December 2024
Division of Oncology, Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Background: The use of stereotactic body radiotherapy (SBRT) to definitively treat oligometastases in prostate cancer has drawn large clinical and research interests within radiation oncology. However, the evidence is considered in its early stages and there is currently no systematic review of randomized controlled trials (RCTs) in this field. We aimed to evaluate the efficacy and safety of SBRT as metastasis-directed therapy (MDT) in oligometastatic prostate cancer (OMPC) compared to no MDT reported in RCTs.
View Article and Find Full Text PDFBJR Open
January 2024
Division of Radiotherapy and Imaging, Institute of Cancer Research, London, SW3 6JB, United Kingdom.
Curr Opin Urol
November 2024
Department of Urology.
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