Predictive Value of the Prostate-specific Antigen Doubling Time for the Effectiveness of Metastasis-directed Radiotherapy in Patients With Oligometastases After Radical Treatment for Non-metastatic Prostate Cancer

Overview

Journal Cancer Diagn Progn

Specialty Oncology

Date 2024 Sep 6

PMID 39238621

Authors

Dai Koguchi

Ken-Ichi Tabata

Shuhei Hirano

Soichiro Shimura

Takefumi Satoh

Masaomi Ikeda

Kazumasa Matsumoto

Yuzuru Niibe

Masatsugu Iwamura

Affiliations

Soon will be listed here.

Abstract

Background/aim: Data on metastasis-directed radiotherapy (MDRT) are limited, particularly regarding its association with the prostate-specific antigen (PSA) doubling time (PSADT). The present study evaluated the oncological outcomes of MDRT on the basis of the PSADT in oligo-recurrent prostate cancer patients.

Patients And Methods: We retrospectively reviewed clinical data of 35 MDRTs for 29 patients at the Kitasato University Hospital, targeting oligometastatic prostate cancer developed after radical treatment for non-metastatic prostate cancer. Thirty-five MDRTs were classified into the PSADT >3 months (n=25) or PSADT ≤3 months group (n=10). Statistical analyses were performed to compare associations between the two PSADT groups and oncological outcomes such as progression-free survival (PFS) and PSA response after MDRT.

Results: There were no significant differences between the two groups in terms of the clinicopathological features. Kaplan-Meier analysis showed that PFS was significantly better in the PSADT >3 months group than in the PSADT ≤3 months group [median: 13.3 versus (vs.) 2.6 months, p=0.046]. Regarding castration sensitivity, the predictive role of PSADT >3 months was maintained in 21 patients who received MDRT without prior salvage hormone therapy (median PFS: 12.7 vs. 2.6 months, p=0.024). In the castration-resistant setting (n=14), the frequency of a decrease in serum PSA levels after MDRT by 90% was 54.5% (median PFS: 23.1 months).

Conclusion: MDRT can provide benefit especially for patients with PSADT ≥3 months who had oligo-recurrence after the radical treatment for non-metastatic prostate cancer.

References

Francini E, Gray K, Xie W, Shaw G, Valenca L, Bernard B . Time of metastatic disease presentation and volume of disease are prognostic for metastatic hormone sensitive prostate cancer (mHSPC). Prostate. 2018; 78(12):889-895. PMC: 6171350. DOI: 10.1002/pros.23645. View

Kawai T, Taguchi S, Nozaki K, Kimura N, Oshina T, Iwaki T . Prostate-specific antigen doubling time predicts the efficacy of site-directed therapy for oligoprogressive castration-resistant prostate cancer. Prostate Int. 2024; 11(4):239-246. PMC: 10772157. DOI: 10.1016/j.prnil.2023.10.002. View

Nagata Y, Jojima K, Matsukawa T, Tomisaki I, Fujimoto N . Initial-to-nadir Prostate-specific Antigen Ratio Predicts Response to First-line Enzalutamide in Metastatic Castration-resistant Prostate Cancer. Anticancer Res. 2023; 43(10):4573-4581. DOI: 10.21873/anticanres.16651. View

Markowski M, Chen Y, Feng Z, Cullen J, Trock B, Suzman D . PSA Doubling Time and Absolute PSA Predict Metastasis-free Survival in Men With Biochemically Recurrent Prostate Cancer After Radical Prostatectomy. Clin Genitourin Cancer. 2019; 17(6):470-475.e1. PMC: 9774681. DOI: 10.1016/j.clgc.2019.08.002. View

Phillips R, Shi W, Deek M, Radwan N, Lim S, Antonarakis E . Outcomes of Observation vs Stereotactic Ablative Radiation for Oligometastatic Prostate Cancer: The ORIOLE Phase 2 Randomized Clinical Trial. JAMA Oncol. 2020; 6(5):650-659. PMC: 7225913. DOI: 10.1001/jamaoncol.2020.0147. View

Andrews J, Ahmed M, Sharma V, Britton C, Stish B, Phillips R . Metastasis-directed Therapy Without Androgen Deprivation Therapy in Solitary Oligorecurrent Prostate Cancer. J Urol. 2022; 208(6):1240-1249. DOI: 10.1097/JU.0000000000002898. View

Jadvar H, Abreu A, Ballas L, Quinn D . Oligometastatic Prostate Cancer: Current Status and Future Challenges. J Nucl Med. 2022; 63(11):1628-1635. PMC: 9635685. DOI: 10.2967/jnumed.121.263124. View

Gomez P, Manoharan M, Kim S, Soloway M . Radionuclide bone scintigraphy in patients with biochemical recurrence after radical prostatectomy: when is it indicated?. BJU Int. 2004; 94(3):299-302. DOI: 10.1111/j.1464-410X.2004.04927.x. View

Niibe Y, Hayakawa K . Oligometastases and oligo-recurrence: the new era of cancer therapy. Jpn J Clin Oncol. 2010; 40(2):107-11. PMC: 2813545. DOI: 10.1093/jjco/hyp167. View

10.

Zhang-Yin J, Montravers F, Montagne S, Hennequin C, Renard-Penna R . Diagnosis of early biochemical recurrence after radical prostatectomy or radiation therapy in patients with prostate cancer: State of the art. Diagn Interv Imaging. 2022; 103(4):191-199. DOI: 10.1016/j.diii.2022.02.005. View

11.

Palma D, Olson R, Harrow S, Gaede S, Louie A, Haasbeek C . Stereotactic Ablative Radiotherapy for the Comprehensive Treatment of Oligometastatic Cancers: Long-Term Results of the SABR-COMET Phase II Randomized Trial. J Clin Oncol. 2020; 38(25):2830-2838. PMC: 7460150. DOI: 10.1200/JCO.20.00818. View

12.

Ost P, Reynders D, Decaestecker K, Fonteyne V, Lumen N, De Bruycker A . Surveillance or Metastasis-Directed Therapy for Oligometastatic Prostate Cancer Recurrence: A Prospective, Randomized, Multicenter Phase II Trial. J Clin Oncol. 2017; 36(5):446-453. DOI: 10.1200/JCO.2017.75.4853. View

13.

Ceci F, Uprimny C, Nilica B, Geraldo L, Kendler D, Kroiss A . (68)Ga-PSMA PET/CT for restaging recurrent prostate cancer: which factors are associated with PET/CT detection rate?. Eur J Nucl Med Mol Imaging. 2015; 42(8):1284-94. DOI: 10.1007/s00259-015-3078-6. View

14.

Mun Chow K, So W, Lee H, Lee A, Yap D, Takwoingi Y . Head-to-head Comparison of the Diagnostic Accuracy of Prostate-specific Membrane Antigen Positron Emission Tomography and Conventional Imaging Modalities for Initial Staging of Intermediate- to High-risk Prostate Cancer: A Systematic Review and.... Eur Urol. 2023; 84(1):36-48. DOI: 10.1016/j.eururo.2023.03.001. View

15.

Johnstone P, Moore E, Carrillo R, Goepfert C . Yield of mammography in selected patients age < or = 30 years. Cancer. 2001; 91(6):1075-8. DOI: 10.1002/1097-0142(20010315)91:6<1075::aid-cncr1102>3.0.co;2-6. View

16.

Tabata K, Niibe Y, Satoh T, Tsumura H, Ikeda M, Minamida S . Radiotherapy for oligometastases and oligo-recurrence of bone in prostate cancer. Pulm Med. 2012; 2012:541656. PMC: 3444052. DOI: 10.1155/2012/541656. View

17.

Yoshida S, Matsushima H, Fujii Y . Classification of oligometastatic prostate cancer with additional consideration for hormone sensitivity. World J Urol. 2021; 40(3):871-873. DOI: 10.1007/s00345-020-03570-9. View

18.

Niibe Y, Chang J . Novel insights of oligometastases and oligo-recurrence and review of the literature. Pulm Med. 2012; 2012:261096. PMC: 3432385. DOI: 10.1155/2012/261096. View

19.

Hellman S, Weichselbaum R . Oligometastases. J Clin Oncol. 1995; 13(1):8-10. DOI: 10.1200/JCO.1995.13.1.8. View

20.

Niibe Y, Kenjo M, Kazumoto T, Michimoto K, Takayama M, Yamauchi C . Multi-institutional study of radiation therapy for isolated para-aortic lymph node recurrence in uterine cervical carcinoma: 84 subjects of a population of more than 5,000. Int J Radiat Oncol Biol Phys. 2006; 66(5):1366-9. DOI: 10.1016/j.ijrobp.2006.07.1384. View