ESTRO 2024 - Abstract Book

S2632

Clinical - Urology

ESTRO 2024

Purpose/Objective:

In recent years, there has been a growing interest in oligometastatic hormone-sensitive prostate cancer (omHSPCa) and the significant role that new generation imaging plays in guiding metastasis-directed therapy (MDT) using radiotherapy (RT). Despite advancements, the heterogeneity of the chosen imaging modality can sometimes result in inadequate treatment.

This research aims to extensively evaluate the change in clinical practice regarding the chosen imaging method before MDT in PCa, using a historical cohort of metastatic patients.

Material/Methods:

The study encompassed patients diagnosed with metachronous omHSPCa who had ≤ 5 metastases, undergoing RT MDT treatment between 2014 and 2022 at the European Institute of Oncology in Milan, Italy. Analytical techniques employed included the Kruskal-Wallis test and ANOVA. All analyses were conducted using R and RStudio.

Results:

The study encompassed 248 patients and a total of 469 MDTs. Specifically, 46% (113 patients) underwent just one course of MDT, 29% (73 patients) were treated twice, 17% (41 patients) underwent three courses of MDT, 7.3% (18 patients) received four courses of MDT, and 1.2% (3 patients) underwent five courses of MDT. In terms of the imaging methodologies utilized to determine the indication for MDT at the first clinical recurrence, PET Cho was the predominant technique, representing 111 treatments or 45%. This was followed by PET PSMA, which accounted for 92 treatments or 37%. RM WB was used for 39 treatments (16%), and conventional imaging techniques were chosen in 6 cases, making up 2.4%. Notably, when comparing the average number of lesions detected by each imaging method, no statistically significant difference was observed in their median values, with a p-value of 0.32 (as depicted in Figure 1).