Node Oligorecurrence in Prostate Cancer: A Challenge.

Fecha de publicación: 17/08/2023 Fecha Ahead of Print: 17/08/2023

Autores de IIS La Fe

• Antonio Conde Moreno

  Autor

Participantes ajenos a IIS La Fe

• Zapatero A
• Barrado Los Arcos M
• Aldave D

Grupos

• Investigación Clínica y Traslacional en Cáncer

  

  Leader

  José Gómez Codina

Abstract

Within the oligometastatic state, oligorecurrent lymph node disease in prostate cancer represents an interesting clinical entity characterized by a relatively indolent biology that makes it unique: it can be treated radically, and its treatment is usually associated with a long period of control and excellent survival. Additionally, it is an emergent situation that we are facing more frequently mainly due to (a) the incorporation into clinical practice of the PSMA-PET that provides strikingly increased superior images in comparison to conventional imaging, with higher sensitivity and specificity; (b) the higher detection rates of bone and node disease with extremely low levels of PSA; and (c) the availability of high-precision technology in radiotherapy treatments with the incorporation of stereotaxic body radiotherapy (SBRT) or stereotaxic ablative radiotherapy (SABR) technology that allows the safe administration of high doses of radiation in a very limited number of fractions with low toxicity and excellent tolerance. This approach of new image-guided patient management is compelling for doctors and patients since it can potentially contribute to improving the clinical outcome. In this work, we discuss the available evidence, areas of debate, and potential future directions concerning the utilization of new imaging-guided SBRT for the treatment of nodal recurrence in prostate cancer.

Keywords

• PSMA-PET; clinical trials; metastasis-directed therapy; oligometastases; oligorecurrent prostate cancer; prostate cancer; stereotaxic body radiotherapy (SBRT)