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dc.contributor.authorDe Bleser, Een_US
dc.contributor.authorJereczek-Fossa, BAen_US
dc.contributor.authorPasquier, Den_US
dc.contributor.authorZilli, Ten_US
dc.contributor.authorVan As, Nen_US
dc.contributor.authorSiva, Sen_US
dc.contributor.authorFodor, Aen_US
dc.contributor.authorDirix, Pen_US
dc.contributor.authorGomez-Iturriaga, Aen_US
dc.contributor.authorTrippa, Fen_US
dc.contributor.authorDetti, Ben_US
dc.contributor.authorIngrosso, Gen_US
dc.contributor.authorTriggiani, Len_US
dc.contributor.authorBruni, Aen_US
dc.contributor.authorAlongi, Fen_US
dc.contributor.authorReynders, Den_US
dc.contributor.authorDe Meerleer, Gen_US
dc.contributor.authorSurgo, Aen_US
dc.contributor.authorLoukili, Ken_US
dc.contributor.authorMiralbell, Ren_US
dc.contributor.authorSilva, Pen_US
dc.contributor.authorChander, Sen_US
dc.contributor.authorDi Muzio, NGen_US
dc.contributor.authorMaranzano, Een_US
dc.contributor.authorFrancolini, Gen_US
dc.contributor.authorLancia, Aen_US
dc.contributor.authorTree, Aen_US
dc.contributor.authorDeantoni, CLen_US
dc.contributor.authorPonti, Een_US
dc.contributor.authorMarvaso, Gen_US
dc.contributor.authorGoetghebeur, Een_US
dc.contributor.authorOst, Pen_US
dc.coverage.spatialSwitzerlanden_US
dc.date.accessioned2019-08-08T14:57:23Z
dc.date.issued2019-07-19en_US
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/31331782en_US
dc.identifierS0302-2838(19)30533-0en_US
dc.identifier.citationEur Urol, 2019en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3320
dc.identifier.eissn1873-7560en_US
dc.identifier.doi10.1016/j.eururo.2019.07.009en_US
dc.description.abstractBACKGROUND: Stereotactic body radiotherapy (SBRT) and elective nodal radiotherapy (ENRT) are being investigated as metastasis-directed treatments in oligorecurrent prostate cancer (PC); however, comparative data are still lacking. OBJECTIVE: To compare outcome and toxicity between both treatments. Primary endpoint was metastasis-free survival, adjusted for selected variables (aMFS). DESIGN, SETTING, AND PARTICIPANTS: This was a multi-institutional, retrospective analysis of 506 (SBRT: 309, ENRT: 197) patients with hormone-sensitive nodal oligorecurrent PC (five or fewer lymph nodes (LNs; N1/M1a), treated between 2004 and 2017. Median follow-up was 36 mo (interquartile range 23-56). INTERVENTION: SBRT was defined as a minimum of 5 Gy per fraction to each lesion with a maximum of 10 fractions. ENRT was defined as a minimum dose of 45 Gy in up to 25 fractions to the elective nodes, with or without a simultaneous boost to the suspicious node(s). The choice of radiotherapy (RT) was at the discretion of the treating physician, with treatments being unbalanced over the centers. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: In total, 506 patients from 15 different treatment centers were included. Primary treatment was radical prostatectomy, RT, or their combination. Nodal recurrences were detected by positron emission tomography/computer tomography (97%) or conventional imaging (3%). Descriptive statistics was used to summarize patient characteristics. RESULTS AND LIMITATIONS: ENRT was associated with fewer nodal recurrences compared with SBRT (p < 0.001). In a multivariable analysis, patients with one LN at recurrence had longer aMFS after ENRT (hazard ratio: 0.50, 95% confidence interval 0.30-0.85, p = 0.009). Late toxicity was higher after ENRT compared with that after SBRT (16% vs. 5%, p < 0.01). Limitations include higher use of hormone therapy in the ENRT cohort and nonstandardized follow-up. CONCLUSIONS: ENRT reduces the number of nodal recurrences as compared with SBRT, however at higher toxicity. Our findings hypothesize that ENRT should be preferred to SBRT in the treatment of nodal oligorecurrences. This hypothesis needs to be evaluated in a randomized trial. PATIENT SUMMARY: This study investigated the difference between stereotactic and elective nodal radiotherapy in treating limited nodal metastatic prostate cancer. Nodal relapse was less frequent following elective nodal radiotherapy than following stereotactic body radiotherapy, and thus elective nodal radiotherapy might be the preferred treatment.en_US
dc.languageengen_US
dc.language.isoengen_US
dc.rights.urihttp://www.rioxx.net/licenses/under-embargo-all-rights-reserveden_US
dc.subjectElective nodal radiotherapyen_US
dc.subjectMetastasis-directed therapyen_US
dc.subjectOligometastasisen_US
dc.subjectOligorecurrenceen_US
dc.subjectProstatic neoplasmsen_US
dc.subjectRadiotherapyen_US
dc.subjectRecurrenceen_US
dc.subjectStereotactic ablative body radiotherapyen_US
dc.subjectStereotactic body radiotherapyen_US
dc.titleMetastasis-directed Therapy in Treating Nodal Oligorecurrent Prostate Cancer: A Multi-institutional Analysis Comparing the Outcome and Toxicity of Stereotactic Body Radiotherapy and Elective Nodal Radiotherapy.en_US
dc.typeJournal Article
dcterms.dateAccepted2019-07-05en_US
rioxxterms.versionofrecord10.1016/j.eururo.2019.07.009en_US
rioxxterms.licenseref.startdate2019-07-19en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfEur Urolen_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Stereotactic and Precision Body Radiotherapy
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Stereotactic and Precision Body Radiotherapy/Stereotactic and Precision Body Radiotherapy (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished onlineen_US
pubs.embargo.termsNot knownen_US
icr.researchteamStereotactic and Precision Body Radiotherapyen_US
dc.contributor.icrauthorvan As, Nicken_US
dc.contributor.icrauthorTree, Alisonen_US


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