ESTRO 2024 - Abstract Book

S2554

Clinical - Urology

ESTRO 2024

Material/Methods:

Sixteen consecutive patients treated from August 2021 to April 2023 were reviewed. Patients were staged using MRI, CT and/or PSMA PET- CT. Patient’s characteristics, radiation doses/techniques, treatment tolerance and toxicities data were prospectively collected. Toxicities were recorded weekly during radiotherapy and every 3 months thereafter using CTCAE v5.0. Thirteen patients received moderately hypo-fractionated radiotherapy, 68 Gy in 25 fractions, and 3 received conventional radiotherapy, 78 Gy in 39 fractions to the gross pelvic disease. When para-aortic nodes were positive, they received 60 Gy in 25 fractions. Uninvolved nodes received 45 to 50 Gy in 25 fractions. Patients with bone metastases were treated with SBRT 30-40 Gy in 5 consecutive fractions. All patients were receiving ADT.

Results:

Median patient’s age was 70 years (range 48 -97). Four patients had metastasis to regional nodes, and 12 had distant metastases. Median initial PSA was 22.5 ng/ml (range 14.8-153).

Median follow up was 13.5 months (Range 5-23). All the patients were in biochemical remission at the last follow up. Fourteen patients had undetectable PSA below 0.006, and 2 patients had PSA of 0.5 ng/ml. Ten patients had grade 1 and one had grade 2 acute genitourinary (GU) toxicity. Two patients had grade 1 and one had grade 2 acute gastrointestinal (GI) toxicity. No other acute toxicities were observed. At last follow up, 4 patients had grade 1 GU toxicity and none had GI toxicity.

Conclusion:

Radical doses of radiation therapy to the primary and metastatic sites in patients with low burden metastatic prostate cancer treated at our institution was well tolerated with very favorable early biochemical response. Contrary to focal radiotherapy to prostate gland in the metastatic setting, in our study radiotherapy to all the gross disease resulted in a pronounced PSA response. Longer follow up and prospective randomized trials will be required to confirm these findings, and are underway.

Keywords: metastatic, prostate, curative, radiotherapy

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