Table 1 Overview of publications included in the systematic review reporting metastasis-directed radiotherapy for oligometastatic prostate cancer
From: Radiotherapy of oligometastatic prostate cancer: a systematic review
Source | Year | Study design | Maximal numbers of metastases | n (patients/lesions) | Median FU (month) | Imaging method | Site of metastases | Median dose (range) and fractions | Concomitant ADT (%) | Median ADT-FS (month) | Local control | PFS |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Jereczek-Fossa [82] | 2012 | Retrospective analysis | 1 | 19/19 | 16.9 | CT, Bone Scan, Choline-PET/CT | LN 95%, Bone 5% | LN 33 Gy/3 fr, Bone 36 Gy/3 fr | 74% | NR | 100% (at last FU, median 16.9 mo) | 42.6% (30-month PFS) |
Tabata [30] | 2012 | Retrospective analysis | 5 | 35/NR | 36 | NR | Bone 100% | 40 Gy (30–50 Gy)/10–25 fr | 100% | – | NR | NR |
Ahmed [61] | 2013 | Retrospective analysis | 5 | 17/21 | 6 | CT, MRI, Choline-PET/CT | LN 5%, bone 90%, viscera 5% | LN 50 Gy/5 fr, Bone: 20 Gy (18–30 Gy)/1–3 fr, Liver 60 Gy/3 fr | 88% | NR | 100% (6 mo) | 74/40% (1-/2-year FFDP) |
Berkovic [14] | 2013 | Retrospective analysis | 3 | 24/29 | 24 | MRI, Bone Scan, FDG-PET/CT, Choline-PET/CT | LN 45%, bone 55% | 50 Gy (40–50 Gy)/10 fr (8–10) | 0% | 38 | 100% (2 year) | 72/42% (1-/2-year CPFS) |
Muacevic [31] | 2013 | Retrospective analysis | 2 | 40/64 | 10 | Choline-PET/CT | Bone 100% | 20 Gy (16.5–22 Gy)/1 fr | 48% | NR | 95.5% (2 year) | NR |
Schick [6] | 2013 | Retrospective analysis | 4 | 50/79 | 31 | MRI, Bone Scan, Choline-PET/CT | LN 63.5%, bone 31.5%, viscera 5% | pelvic LN: 50.4 Gy + Boost to median 65 Gy (44–74 Gy) Bone 28–36 Gy/5–6 fr | 98% | NR | NR | 58.6/54.5% (3-year CFFS/BPFS) |
Decaestecker [15] | 2014 | Prospective analysis | 3 | 50/70 | 24 | MRI, Choline-PET/CT, FDG-PET/CT | LN 54%, bone 44%, viscera 2% | 50 Gy/10 fr, or 30 Gy/3 fr | 70% | 25 | 100% (2 year) | 64/35% (1-/2-year) |
Detti [83] | 2015 | Retrospective analysis | 2 | 30/39 | 12 | CT, MRI, Choline-PET/CT | LN 100% | Most commonly used 30 Gy (24–36 Gy)/3 fr (1–5) | 47% | NR | 100% (1 year) | NR |
Ponti [57] | 2015 | Retrospective analysis | 2 | 16/18 | 29 | Choline-PET/CT | LN 100% | 35 Gy (12–35 Gy)/5 fr (1–5) | 63% | Mean 23.7 | 94% (6 mo) | 45% (2-year BPFS) |
Muldermans [7] | 2016 | Retrospective analysis | 5 | 66/81 | 16 | CT, MRI, Bone Scan, Choline-PET/CT | LN 7.4%, bone 91%, viscera 1% | 16 Gy (16–50 Gy)/1 fr (1–5) | 64% | NR | 82% (2 year) | 45/54% (2-year DPFS/BPFS) |
Napieralska [75] | 2016 | Retrospective analysis | 4 | 18/31 | 16 | CT, MRI, Choline-PET/CT | LN 100% | 30 Gy (24–45 Gy), 2–5 fr | 100% | – | 93/70% (1/2 year) | NR |
Ost [16] | 2016 | Retrospective analysis | 3 | 119/163 | 36 | MRI, Choline-PET/CT, FDG-PET/CT | LN 60%, bone 36%, mixed 2%, viscera 1% | ≥ 80 Gy BED (α/β 3), SD ≥ 5 Gy | 50% | Median time from first SBRT to palliative ADT: 28 m | 93/92% (3/5 year) | 31/15% (3-/5-year DPFS) |
Pasqualetti [17] | 2016 | Prospective clinical trial | 3 | 29/45 | 12 | Choline-PET/CT | LN 56%, bone 44% | 24 Gy/1 fr or 27 Gy/3 fr | 0% | 39.7 | 100% (at last FU, median 12 mo) | NR |
Wu [8] | 2016 | Retrospective analysis | 3 | 30/53 | 33 | Bone Scan, Choline-PET/CT | Bone 100% | Short-Course: 20-30 Gy/5–10 fr, Long-course 37.5–50 Gy/15–25 fr | 100% | – | 75% (3 year) | 22.8% (3-year) |
Bouman-Wammes [46] | 2017 | Retrospective double arm | 4 | 43/55 | 31 | Choline-PET/CT | LN (77%), bone (21%), mixed (2) | Most commonly used 30 Gy/3 fr and 35 Gy/5 fr | 0% | 15.6 m | 100% (at last FU, median 2.6 year) | NR |
Fodor [26] | 2017 | Retrospective analysis | 2 | 81/NR | 36 | Choline-PET/CT | LN (100%) | 51.8 Gy/28 fr + SIB 65.5 Gy (TD 50–65 Gy/25–30 fr) | 72% | NR | 89.8% (3 year) | 61.8/42.4%(3-year CRFS/BPFS) |
Habl [32] | 2017 | Retrospective analysis | 2 | 15/20 | 23 | MRI, PSMA-PET/CT, Choline-PET/CT | Bone 100% | 25–40 Gy | 20% | 9.3 | 100% (2 year) | NR |
Ingrosso [71] | 2017 | Retrospective analysis | 2 | 40/47 | 24 | Choline-PET/CT | LN 100% | Most commonly used: 35 Gy/5 fr and 40 Gy/8 fr (12–50 Gy/1–5 fr) | 48% | Mean 26 | 98% (30 mo) | 44% (2-year BPFS) |
Jereczek-Fossa [9] | 2017 | Retrospective analysis | 5 | 94/124 | 19 | CT, MRI, Choline-PET/CT | LN 100% | Most commonly used: 24 Gy (15–36 Gy)/3 fr ( 3–6) | 36% | 7 | 84% (2 year) | 30% (2-year) |
Triggiani [18] | 2017 | Retrospective double arm | 3 | 141/209 | OR: 20.4/OP: 23.4 | CT, Bone Scan, Choline-PET/CT | LN 84.1.%/70%, bone 15.8%/30% | 116 Gy BED (80–216.6 Gy) (α/β 3 Gy) | 24% | OR: 21/OP: 22 (second systemic therapy-free survival) | OR: 92.8%/OP: 90.2% (2 year) | OR: 64.4/43/26.6% (1-/2-/3-year) OP: 43.2/21.6/11.9% |
Baumann [45] | 2018 | Retrospective analysis | 5 | 5/18 | 11 | PSMA-PET/CT | LN 21%, bone 79% | 35 Gy/5 fr | 0% | NR | 88% (at last FU, median 11 mo, determined by PET-response) | NR |
Fanetti [33] | 2018 | Retrospective analysis | 5 | 55/77 | 25 | MRT, PSMA-PET/CT, Choline-PET/CT | Bone 100% | 24 Gy (15-30 Gy)/3 fr (1–5) | 55% | NR | 83/76% (1/2 year) | 55/27% (1-/2-year CPFS), 51/13% (1-/2-year BPFS) |
Franzese [19] | 2018 | Retrospective analysis | 3 | 64/90 | 15.2 | Bone Scan, Choline-PET/CT | LN 78%, bone 16%, mixed 3%, viscera 3% | 42 Gy (18–60)/2–8 fr | 42% | NR | 88/84% (1/1.5 year) | 52/37% (1-/1.5-year DPFS), 38/25% (1-/1.5-year CPFS) |
Guler [50] | 2018 | Retrospective analysis | 3 | 23/38 | 7 | PSMA-PET/CT | LN 43%, bone 43%, both 23% | 45 Gy (30–64 Gy)/15 fr (12–27) | 100% | – | 100% (1 year) | 51% (1 year) |
Lépinoy [59] | 2018 | Retrospective double arm | 4 | 62/88 | 42 | Choline-PET/CT | LN 100% | Extended field: 45–59 Gy in 1.8–2.2 Gy + Boost to median 66 Gy Involved field: 36 Gy (30–66) in 7.5 Gy (2–15) | 24% | NR | NR | Extended field: 88.3%/involved field: 55.3% (3-year FFR) |
Oertel [21] | 2018 | Retrospective analysis | LN 5/Bone 1 | 27/37 | NR | CT, MRI, PSMSA-PET/CT, Choline-PET/CT | LN 79%, bone 30% | LN: 63 Gy (30.6–70.2 Gy), Bone: 54 Gy (30–66.6 Gy) | 74% | NR | 100% (2 year) | LN: 75.4/58.7% (1-/2-year MFS), Bone: 100/83.3% |
Ost [60] | 2018 | Prospective randomized phased II study | 3 | Surveillance: 31/65, MDT 31/51 | 36 | Choline-PET/CT | LN 55%, bone 39%, mixed 5%, viscera 2% | 30 Gy/3 fr | 0% | 21 versus 13 (p = 0.11) | 100 vs. 77% at last FU, median 36 mo | NR |
Siva [62] | 2018 | Prospective clinical trial | 3 | 33/50 | 24 | CT, Bone Scan, NaF-PET/CT | LN 36%, bone 61%, mixed 3% | 20 Gy/1 fr | 33% | 2 year ADT-FS: 48% | 97/93% (1/2 year) | 58/39% (1-/2-year DPFS) |
Steuber [84] | 2018 | Retrospective matched pair analysis | 5 | 263/NR | 70 | Choline-PET/CT | LN 100% | ≥ 80 Gy BED (α/β 3), SD ≥ 5 Gy | NR | NR | NR | NR |
Tran [76] | 2018 | Retrospective analysis | 5 | 53/108 | 44 | MRI, Bone scan, Choline-PET/CT, | LN 100% | 45–50.4 Gy on involved LN regions, Boost median to 64.4 (54–69) | 100% | – | 96.3% (at last FU, median 44 mo) | 58.2/43%(5-year DPFS/BPFS) |
Henkenberens [51] | 2018 | Retrospective analysis | 2 | 29/NR | 8 | PSMA-PET/CT | LN 58.6%, Bone (20.7%), mixed 3.4% | LN (50.4–54.0 Gy), Bone (40 Gy à 2.5 Gy 4x/week) | 28% | NR | 100% (at last FU, median 8 mo) | 75% (1-year DMFS and BPFS) |
Loi [85] | 2018 | Retrospective analysis | 2 | 23/27 | 22 | Choline-PET/CT | LN 100% | 24 Gy/1 fr | 0% | NR | NR | 65/40/26% (6-mo/1-year /2-year BPFS) |
Soldatov [54] | 2018 | Retrospective analysis | 5 | 108/284 | 18 | PSMA-PET/CT | LN 59%, bone 39.6%, viscera 1.4% | LN 50.4–60 Gy in 1.8 Gy, Bone 40 Gy in 2.5 Gy 4x/week | NR | NR | 96,3% (at last FU, median 18 mo) | 56,5% (BPFS at 18 mo) |
Kneebone [20] | 2018 | Prospective clinical trial | 3 | 57/73 | 16 | PSMA-PET/CT | LN 65%, bone 31%, mixed 4% | LN 30 Gy/3 fr or 50 Gy/5 fr, Bone 20 Gy/1 fr or 24 Gy/2 fr | 0% | NR | 100% (at last FU, median 16 mo) | 46/16% (1-/2-year BPFS) |
Cysouw [10] | 2018 | Retrospective analysis | 4 | 40/50 | 33 | Choline-PET/CT | LN 74%, bone 26% | 35 Gy/5 fr or 30 Gy/3 fr | NR | NR | NR | NR |
Patel [34] | 2019 | Retrospective analysis | 3 | 51/64 | 23 | MRI, Bone Scan PSMA-PET/CT, Choline-PET/CT | Bone 100% | 30 Gy (24–30 Gy)/3–6 Gy SD | 79% | NR | 98/95/90% (1/2/3 year) | 45/38% (1-/2-year PFS) |
Triggiani [24] | 2019 | Retrospective analysis | 5 | 86/117 | 31 | Bone Scan, Choline-PET/CT | LN 67%, bone 33% | LN 36 Gy/6 fr or 45 Gy/6 fr; Bone 24 Gy/3 fr | 0% | Median systemic treatment-free survival 21.8 | 80% (at last FU, median 31 mo) | 52/34% (1-/2-year DPFS) |
De Bleser [48] | 2019 | Retrospective analysis | 5 | 506/764 | 36 | CT, MRI, PSMA-PET/CT, Choline-PET/CT, FDG-PET/CT | LN 100% | SBRT minimal SD 5 Gy, maximum of 10 fractions; ENRT: minimal TD 45 Gy/up to 25 fx | SBRT: 23%, ENRT: 60% | NR | NR | 68/77% (SBRT vs. ENRT 3-year MFS, p = 0.01) |
Bowden [22] | 2019 | Prospective clinical trial | 5 | 199/NR | 35 | MRI, Bone Scan, PSMA-PET/CT, Choline-PET/CT | LN 63.3%, bone 22.6%, mixed 12.1%, viscera 2% | 50 Gy/10 fr | 7% | Median treatment escalation-free survival: 27.1 | NR | NR |
Gomez-Iturriaga [63] | 2019 | Prospective clinical trial | 5 | 49/102 | 24 | MRI, Choline-PET/CT | LN 69.4%, bone 26.5%, mixed 4.1% | Bone 24–30 Gy/3 fr, LK 45 Gy + SIB 58 Gy/25 fr or 24 -30 Gy/3 fr | Yes, proportion NR | NR | 91.8% (at last FU, median 24 mo) | 71% at last FU, 2-year BPFS: 74.2% |
Artigas [42] | 2019 | Retrospective analysis | 3 | 20/30 | 15 | PSMA-PET/CT | LN 60%, bone 30%, viscera 10% | 30 Gy/3 fr or Pelvic + SIB up to 66 Gy | 0% | 2 year ADT-FS: 74% | NR | 79/53% (1-/2-year BPFS) |
Franzese [49] | 2019 | Retrospective analysis | 5 | 92/119 | 22 | PSMA-PET/CT, Choline-PET/CT | LN 76%, bone 24%, viszera 3% | 42 Gy (18–60 Gy)/2–8 fr | NR | NR | 90.9/85.5% (1/3 year) | 51.9/20.9% (1-/3-year DPFS), 42.8/16.7% (1-/3-year PFS) |
Ong [23] | 2019 | Retrospective analysis | 3 | 20/26 | 16 | PSMA-PET/CT | LN 75%, bone 15%, mixed 10% | Bone 30 Gy/3 fr, LK 35–40 Gy/5 fr | 0% | 1-year ADT-FS: 70% | 93% (1 year) | 62% (1-year) |
Nicosia [53] | 2019 | Retrospective analysis | 5 | 109/155 | 16 | PSMA-PET/CT, Choline-PET/CT | LN 100% | 36 Gy (25–48 Gy)/4–7 fr | 46% | 15 | 93/87% (1/2 year) | 55/33% (1-/2-year PFS), 64/52% (1-/2-year nodal PFS) |
Berghen [47] | 2019 | Retrospective analysis | 3 | 30/45 | 18 | CT, MRI, PSMA-PET/CT, Choline-PET/CT | LN 17%, Bone 66%, both 3%, viscera 3%, | SBRT: EQD2 78–142.8 Gy/3–5 fr, fractionated: 39 Gy/13 fr | NR | Median NEST-FS: 16 mo | NR | median PFS 10 mo |
Deantoni [35] | 2020 | Retrospective analysis | 2 | 39/51 | 47 | CT, Bone Scan, Cholin-PET/CT | Bone 100% | 44 Gy | 100% | – | 95% (at last FU, median 43 mo) | 65.7/53.3 (4-year CPFS/BPFS) |
Schmidt-Hegemann [64] | 2020 | Retrospective analysis | 5 | 135/135 | 16 | PSMA-PET/CT, PSMA-PET/MRI | LN 38%, bone or viscera 62% | LN: 50.9 Gy, Bone 56 Gy, Viscera: 93.93 Gy (EQD2, α/β 1.5) | 35% | NR | 91% at last FU, median 16 month | 46% at last FU, median 16 month |
Phillips [13] | 2020 | Prospective randomized phased II study | 3 | 54 (36 SBRT, 18 observation)/73 | 19 | CT, MRT, Bone Scan | LN only 58%, bone-involved 42% | 19.5–48 Gy/3–5 fr | 0% | NR | 98.9% (6-mo) | 19 vs 61% (6-mo PFS), 11 vs 50% (6-mo BPFS) |
Oehus [25] | 2020 | Retrospective analysis | 5 bone or viscera, no limit for LN | 78/185 | 16 | PSMA-PET/CT | LN 69.2%, bone 24.3%, 6.5% viscera | LN: 50.9 Gy, Bone 51.4 Gy, Viscera: 64.7 Gy (EQD2, α/β 1.5) | 16.7% | 34 | NR | 55% 1-year bRFS |
Koerber [72] | 2020 | Retrospective analysis | 5 | 86/168 | 26 | PSMA-PET/CT | LN 63%, bone 37% | SBRT: 27–37,5/3–5 fr, 61.2 Gy/34fr | 61.9 | 13.5 | 90.9% at median 13 mo | 85/55% (2/3 year BRFS) |
Hurmuz [11] | 2020 | Retrospective analysis | 5 | 176/353 | 23 | PSMA-PET/CT | LN 43%, bone 35%, both 23% | 27 Gy (15–40 Gy)/1–5 fr, 60 (40–78) Gy/25–39 fr | 79.5% | NR | 93.2% (2-year) | 63.1% (2 year BPFS) |
Devos [58] | 2020 | Retrospective analysis | 5 | 191/350 | 45 | CT, Bone Scan, Cholin-PET/CT, PSMA-PET/CT | LN 71%, bone 24%, viscera 6% | 30 Gy/3 fr or 62.5/25 fr | 61% | 66 month | NR | median BRFS 8 month, median CPFS: 30 month |
Reverberi [65] | 2020 | Retrospective analysis | 5 | 37/NR | 56 | MRI, Cholin-PET/CT | LN 57%, bone 51%, both 19% | 45–60 Gy/25 fr, SBRT dose NR/1–5 fr | 97.3% | NR | 93.9/83.7% (2/5 year) | 79.1/55.4% (2/5 year CPFS) 73.3./39.3% (2/5 year BPFS) |
Kalinauskaite [12] | 2020 | Retrospective analysis | 5 | 50/75 | 34 | PSMA-PET/CT | LN 48%, bone 46%, both 4%, viscera 2% | 16–28.8 Gy/1–3 fr | 30% | 2 year ADT-FS: 60.5% | 98/96% (1/2 year) | 54/22% (1/2 year BPFS) |
Deek [27] | 2019 | Retrospective analysis | 5 | 156/354 | 25 | CT, MRT, Choline-PET/CT, PSMA-PET/CT, NaF-PET/CT, Fluciclovine-PET/CT, | LN 43%, bone 52%, visceral 3% | 15–20 Gy/1 fr; 24–36 Gy/3 fr, 30–50 Gy/5 fr | 59.6% | 27.8 | 96.1%/93.6% (1/2 year) | 52% 1-year BRFS |
Deek [44] | 2020 | Retrospective analysis | 5 | 258/474 | 25 | CT, MRT, Choline-PET/CT, PSMA-PET/CT, NaF-PET/CT, Fluciclovine-PET/CT, | LN 28%, bone 62%, both 10% | 15–20 Gy/1 fr; 24–36 Gy/3 fr, 30–50 Gy/5 fr | 50.4% | NR | 96/93% (1/2 year) | median BPFS 16 month, median DMFS 19 month |