Stereotactic body radiotherapy for oligometastatic castration sensitive prostate cancer using 1.5 T MRI-Linac: preliminary data on feasibility and acute patient-reported outcomes

Autor: Michele Rigo, D. Gurrera, Ruggero Ruggieri, Francesco Ricchetti, Luca Nicosia, Niccolò Giaj-Levra, Gioacchino Di Paola, Gianluisa Sicignano, Antonio De Simone, Claudio Vitale, Filippo Alongi, Rosario Mazzola, Stefania Naccarato, Francesco Cuccia, Beatrice Mantoan, Vanessa Figlia
Rok vydání: 2021
Předmět:
Male
medicine.medical_specialty
medicine.medical_treatment
Radiosurgery
030218 nuclear medicine & medical imaging
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Quality of life
Positron Emission Tomography Computed Tomography
Medicine
Humans
Radiology
Nuclear Medicine and imaging
Castration
Patient Reported Outcome Measures
Prospective Studies
MRI-Linac
Neuroradiology
Aged
Aged
80 and over
Radiotherapy
medicine.diagnostic_test
business.industry
Prostatic Neoplasms
Common Terminology Criteria for Adverse Events
Interventional radiology
General Medicine
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Radiation therapy
Tolerability
030220 oncology & carcinogenesis
Feasibility Studies
Observational study
Radiology
business
Oligometastases
Radiotherapy
Image-Guided
Zdroj: La Radiologia medica. 126(7)
ISSN: 1826-6983
Popis: To report preliminary data on feasibility and patient-reported outcomes following PSMA-PET/CT guided SBRT by means of 1.5 T MRI-Linac. Between October 2019 and April 2020, twenty consecutive castration sensitive oligorecurrent prostate cancer patients were enrolled in an ethical committee approved prospective observational study (Protocol n. XXXX) and treated with PSMA-PET/CT guided SBRT by means of 1.5 T MRI-Linac (Unity, Elekta AB, Stockholm, Sweden). The mean delivered dose was 35 Gy in 5 fractions. Clinicians reported toxicity was prospectively collected according to Common Terminology Criteria for Adverse Events v5.0. Quality of life (QoL) assessment was performed using EORTC-QLQ C30 questionnaires administered at baseline, end of treatment and at first follow-up. Twenty-five lesions in 20 castration sensitive oligorecurrent patients were treated: the most commonly treated anatomic sites were nodal (n = 16) and pelvic bone (n = 9). Median PSA-value preMRI guided SBRT was 1.16 ng/mL (range, 0.27–8.9), whereas median PSA value at first follow-up after SBRT was 0.44 ng/mL (range, 0.06–8.15). At first follow-up, for 16 patients showing detectable PSA, PSMA-PET/CT was performed detecting, respectively, in 6 cases partial response and in 10 cases complete response. In the remaining cases, PSA-value was undetectable after SBRT. Radiotherapy treatment was safe and well tolerated according to the PROMs. No acute G2 or higher toxicities were recorded. The current series represent the largest one exploring the feasibility and patient-reported outcomes following PSMA-PET/CT guided SBRT by means of 1.5 T MRI-Linac. The preliminary findings here reported are encouraging in terms of effectiveness and tolerability.
Databáze: OpenAIRE
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