論文

国際誌
2021年1月16日

Genuine- and induced-oligometastatic castration-resistant prostate cancer: clinical features and clinical outcomes after progressive site-directed therapy.

International urology and nephrology
  • Soichiro Yoshida
  • ,
  • Taro Takahara
  • ,
  • Yuki Arita
  • ,
  • Kazuma Toda
  • ,
  • Ichiro Yamada
  • ,
  • Hajime Tanaka
  • ,
  • Minato Yokoyama
  • ,
  • Yoh Matsuoka
  • ,
  • Ryoichi Yoshimura
  • ,
  • Yasuhisa Fujii

記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1007/s11255-020-02762-x

PURPOSE: To evaluate the clinical characteristics of genuine- and induced-oligometastatic castration-resistant prostate cancer (OM-CRPC) and assess the therapeutic effect of progressive-site directed therapy (PSDT). METHODS: We performed a retrospective analysis of 45 patients with OM-CRPC. Whole-body diffusion-weighted MRI (WB-DWI) was used to diagnose oligo-progressive disease. Based on the clinical and radiological findings, the OM-CRPCs were classified as genuine or induced. PSDT was performed with the intent to ablate all the progressive sites detected on WB-DWI with radiotherapy. Systemic therapy remained unchanged during and after PSDT. RESULTS: A total of 31 (69%) and 14 (31%) patients were diagnosed with genuine- and induced-OM-CRPC, respectively. The genuine-OM-CRPC group had significantly fewer patients treated with taxane-based chemotherapy and new hormonal drugs than the induced-OM-CRPC group. Of these, 26 OM-CRPC patients were treated with PSDT, and a 50% PSA decline was observed in 14 (93%) of 15 patients with genuine-OM-CRPC and 4 (36%) of 11 patients with induced-OM-CRPC (P = 0.033). Further, the duration of PSA-progression-free survival was significantly longer in the genuine-OM-CRPC group than in the induced-OM-CRPC group (8.7 vs. 5.8 months, P = 0.040). CONCLUSIONS: PSDT can be a promising treatment option for genuine-OM-CRPC. The procedure might also be considered effective for induced-OM-CRPC, although there was less therapeutic benefit of PSDT in patients with induced-OM-CRPC than in patients with genuine-OM-CRPC.

リンク情報
DOI
https://doi.org/10.1007/s11255-020-02762-x
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33452956

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