前列腺癌骨寡轉移經身體立體定位放射治療後的疾病無惡化存活期及不同放射劑量之比較

陳立峰、楊啟瑞

中國醫藥大學附設醫院 泌尿部

Progression-Free Survival Following Stereotactic Body Radiotherapy for Bone Oligometastasis in Prostate Cancer and the Effect of Different Doses: A Single-Urologist, Single-Institute Experience

Lek-Hong Tan, MD, MPH, Chi-Rei Yang, MD

Department of Urology, China Medical University Hospital, Taichung, Taiwan

Purpose:  The understanding of the outcome of stereotactic body radiation therapy (SBRT) for bone oligometastasis in prostate cancer is limited. The purpose of this study was to investigate the progression-free survival (PFS) of bone oligometastasis in prostate cancer, as well as the effect of different doses of SBRT.

Materials and Methods:  We collected data on patients with prostate cancer and bone oligometastasis between January 2014 and March 2023 from the medical records of a single urologist at China Medical University Hospital. Progression-free survival was defined as the time between SBRT and the occurrence of progression in biochemical PSA, imaging study, or death. We used Kaplan-Meier survivor function, log-rank test, and Cox regression to calculate PFS and overall survival. We also described the association (odds ratio [OR]) between different radiotherapy doses and progression outcome.

Results:  Our study included 16 patients with 20 bone metastases who received SBRT. The median PFS was 40 months, and the median (IQR) follow-up from the last radiotherapy treatment was 12 (2.5–28.5) months. Ten patients were treated with a low dose of SBRT (<5000 cGy), and six patients were treated with a high dose (>5000 cGy). The use of high-dose SBRT was associated with decreased disease progression compared to low dose (odds ratio 0.03 [95% CI 0.001-0.838, p<0.05]). No patients experienced grade 3 or 4 toxicities.

Conclusions:  Our findings suggest that patients with prostate cancer and bone oligometastasis have good outcomes after SBRT to all sites of disease and benefit from high-dose SBRT. However, prospective validation of these observations is needed.