Page 84 - Fisica In Medicina n° 1/2017

^Äëíê~Åí=jÉÇáÅá= =CRPC, in terms of distant progression free survival (DPFS) and second line systemic-treatment-free survival (STFS).Materials and Methodsnon-castrate pts with oligorecurrent disease detected with Choline-PET or CT+Scintigraphy following biochemical recurrence were treated with SBRT. BPFS and ADT-FS were the primary endpoint. Secondary endpoints were local control and toxicity. On the other hand, oligo-CRPC pts detected with choline-PET or CT+scintigraphy after PSA rise during ADT were enrolled in the analysis. Primary endpoint were DPFS and STFS. Univariate analysis was performed in order to assess factors influencing outcome in both categories.Results100 pts with oligorecurrent PC (139 lesions; lymph nodes 84.2%, bones 15.8%) were treated from 03/2010 to 02/2016. After a median follow up of 20.4 months, 1yr- and 2yrs-BPFS were 58.1% and 38.3%. 15 pts underwent a second course of SBRT for a further oligoprogression: this result in a median ADT-FS of 20.9 months with 1-, 2-, 3-yrs ADT-FS of 67.4%, 47.3% and 31%. At univariate analysis, low PSA-DT is related with a worse ADT-FS. LC rate was 88,2% at two years. No G3 toxicity was reported. 41 pts with oligo-CRPC (70 lesions) were treated from 01/2010 to 04/2016. After a median follow up of 23.43 months, 1yr- and 2yrs-DPFS were 43.2% and 21.6% with a median DPFS of 11 months. 10 pts underwent a second course of SBRT. At the time of analysis, 20 patients had started systemic treatment (10 pts with Abiraterone or Enzalutamide and 10 pts with Docetaxel): median STFS was 22 months with 1-, 2-, 3-yrs STFS of 74.8%, 41.3% and 29.5%. No significant correlations were found at univariate analysis. No toxicity was registered.ConclusionsSBRT for oligorecurrent PC is an effective treatment and postpones palliative ADT for almost 2 yrs without toxicity. SBRT has proven effective even in oligoprogressive CRPC with a capacity to delay the start of systemic second line therapies for almost 2 yrs.75