MP72-13 LONG-TERM OUTCOMES OF COMBINING PROSTATE BRACHYTHERAPY AND METASTASIS-DIRECTED RADIOTHERAPY IN DE NOVO OLIGOMETASTATIC PROSTATE CANCER: A RETROSPECTIVE COHORT STUDY

You have accessJournal of UrologyProstate Cancer: Localized: Radiation Therapy (MP72)1 Apr 2019MP72-13 LONG-TERM OUTCOMES OF COMBINING PROSTATE BRACHYTHERAPY AND METASTASIS-DIRECTED RADIOTHERAPY IN DE NOVO OLIGOMETASTATIC PROSTATE CANCER: A RETROSPECTIVE COHORT STUDY Hideyasu Tsumura*, Hiromichi Ishiyama, Ken-ichi Tabata, Yasukiyo Murakami, Akane Sekiguchi, Masashi Kitano, Takefumi Satoh, and Masatsugu Iwamura Hideyasu Tsumura*Hideyasu Tsumura* More articles by this author , Hiromichi IshiyamaHiromichi Ishiyama More articles by this author , Ken-ichi TabataKen-ichi Tabata More articles by this author , Yasukiyo MurakamiYasukiyo Murakami More articles by this author , Akane SekiguchiAkane Sekiguchi More articles by this author , Masashi KitanoMasashi Kitano More articles by this author , Takefumi SatohTakefumi Satoh More articles by this author , and Masatsugu IwamuraMasatsugu Iwamura More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000557145.73531.63AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: We evaluated the efficacy and safety of prostate-directed radiotherapy with or without metastasis-directed radiotherapy in de novo oligometastatic patients who underwent combination of high-dose-rate prostate brachytherapy, external beam radiotherapy, and androgen deprivation therapy. METHODS: Forty patients with bone metastasis and node positive prostate cancer were retrospectively analyzed. Of these, 22 (55%), 3 (7%), and 15 (38%) patients had N1M0, M1a, and M1b, respectively. Eighteen patients (45%) received metastasis-directed radiotherapy to all metastatic sites. All patients initially underwent ≥ 6 months of androgen deprivation therapy. Oligometastatic disease was defined as presence of five or fewer metastatic lesions. Median prostate-specific antigen (PSA) at diagnosis and follow-up period was 19.35 ng/ml and 62.5 months, respectively. RESULTS: Of the 40 patients, the 5-year castration-resistant prostate cancer (CRPC)-free survival rate and cancer-specific survival was 64.4% and 87.9%, respectively. Pre-treatment predictive value including PSA at diagnosis ≥ 20 ng/ml (HR 2.722; 95% CI: 1.003-7.392), positive biopsy core rate ≥ 51% (HR 4.677; 95% CI: 1.693-12.92), and Gleason grade group 5 (HR 2.993; 95% CI: 1.246-12.34) were significantly associated with worse outcomes for CRPC-free survival. Patients with metastasis-directed radiotherapy had significantly higher probability of achieving a PSA level of < 0.02 ng/ml than those without the therapy (88.8% vs. 54.5%, p = 0.0354) and consequently had a better CRPC-free survival than those without the therapy (HR 0.319; 95% CI: 0.116-0.877) (Figure 1). Prostate-directed radiotherapy with metastasis-directed radiotherapy did not significantly increase the incidences of genitourinary and gastrointestinal toxicities compared to prostate-directed radiotherapy alone. CONCLUSIONS: This single-institutional study revealed the feasibility of combining prostate brachytherapy and metastasis-directed radiotherapy for de novo oligometastatic prostate cancer. This combined approach has potential to prolong CRPC-free survival. Source of Funding: none Sagamihara, Japan© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e1060-e1060 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hideyasu Tsumura* More articles by this author Hiromichi Ishiyama More articles by this author Ken-ichi Tabata More articles by this author Yasukiyo Murakami More articles by this author Akane Sekiguchi More articles by this author Masashi Kitano More articles by this author Takefumi Satoh More articles by this author Masatsugu Iwamura More articles by this author Expand All Advertisement PDF downloadLoading ...