Nicosia, L.; Trapani, G.; Rigo, M.; Giaj-Levra, N.; Mazzola, R.; Pastorello, E.; Ricchetti, F.; Cuccia, F.; Figlia, V.; Fiorini, M.; Alongi, F. 1.5 T MR-Guided Daily Adapted SBRT on Lymph Node Oligometastases from Prostate Cancer. J. Clin. Med.2022, 11, 6658.
Nicosia, L.; Trapani, G.; Rigo, M.; Giaj-Levra, N.; Mazzola, R.; Pastorello, E.; Ricchetti, F.; Cuccia, F.; Figlia, V.; Fiorini, M.; Alongi, F. 1.5 T MR-Guided Daily Adapted SBRT on Lymph Node Oligometastases from Prostate Cancer. J. Clin. Med. 2022, 11, 6658.
Nicosia, L.; Trapani, G.; Rigo, M.; Giaj-Levra, N.; Mazzola, R.; Pastorello, E.; Ricchetti, F.; Cuccia, F.; Figlia, V.; Fiorini, M.; Alongi, F. 1.5 T MR-Guided Daily Adapted SBRT on Lymph Node Oligometastases from Prostate Cancer. J. Clin. Med.2022, 11, 6658.
Nicosia, L.; Trapani, G.; Rigo, M.; Giaj-Levra, N.; Mazzola, R.; Pastorello, E.; Ricchetti, F.; Cuccia, F.; Figlia, V.; Fiorini, M.; Alongi, F. 1.5 T MR-Guided Daily Adapted SBRT on Lymph Node Oligometastases from Prostate Cancer. J. Clin. Med. 2022, 11, 6658.
Abstract
Introduction: The aim of our study was to evaluate the efficacy and toxicity of a daily-adaptive MR-guided SBRT on 1.5 T MR-linac in patients affected by lymphnode oligometastases from PCa. Materials and Methods: The present study is a prospective observational study conducted in a single institution (protocol n°: MRI / LINAC n. 23748). Patients with oligometastatic lymphnodes from PCa treated with daily-adaptive MR-guided SBRT on 1.5T MR-linac were included in the study. Minimum required follow-up of 3 months after SBRT. Primary end-point was local progression-free survival (LPFS). Secondary end-points were: nodal progression-free survival (NPFS), and progression-free survival (PFS), and toxicity. Results: 118 lymphnode oligometastases from PCa were treated with daily-adaptive 1.5T MR-guided SBRT in 63 oligometastatic patients. 63.5% patients were oligoprogressive and 36.5% oligoprogressive. Two-year LPFS was 94.5%. Median NPFS was 22.3 months, and the 2-year NPFS was 46.5%. Having received hormone therapy before SBRT was correlated with lower NPFS at the multivariate analysis (1-y NPFS 87.1% versus 42.8%; p= 0.002 - HR 0.199, 95% CI 0.073-0.549). Furthermore, the oligorecurrent state during ADT was correlated with a lower NPFS than the oligoprogressive state. Median PFS was 10.3 months, the 2-year PFS was 32.4%. Patients treated with hormone therapy before SBRT had a significantly lower 1-year PFS the others (28% versus 70.4%; p= 0.01 - HR 0.259, 95% CI 0.117-0.574). No acute and late toxicities occurred during treatment. Conclusion: the present is the largest prospective study of 1.5T lymphnode SBRT on MR-linac in patients with PCa. Lymphnode SBRT by 1.5T MR-linac provides high local control rates with an excellent toxicity profile.
Keywords
Adaptive radiotherapy; Lymph node; MR-linac; MRgRT; Oligometastases; SBRT; prostate cancer
Subject
Medicine and Pharmacology, Oncology and Oncogenics
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
,
