Background/Objectives:Oligometastatic prostate cancer (OMPC) represents an early stage of metastatic disease characterized by a limited number of lesions. Recent advancements in imaging and treatment have revived interest in personalized therapies, including metastasis-directed radiotherapy (OMDRT) and primary prostate radiotherapy (PPR). This study evaluates the impact of OMDRT timing and the role of PPR on survival outcomes in OMPC patients;Methods:In this retrospective cohort study, 82 patients with OMPC who underwent OMDRT between 2010 and 2019 were analyzed. Patients were classified based on OMDRT timing (early vs. late) and disease type (synchronous vs. metachronous). Progression-free survival (PFS) and overall survival (OS) were the primary endpoints, assessed via Kaplan-Meier analysis and Cox proportional hazards models;Results:Among the patients, 36 (43.9%) had synchronous and 46 (56.1%) had metachronous OMD. With a median follow-up of 32 months, the 5-year PFS and OS rates were 77.5% and 88.5%, respectively. Early OMDRT significantly improved PFS (HR 0.461, 95% CI: 0.257–0.826,p= 0.009) and OS (HR 0.219, 95% CI: 0.080–0.603,p= 0.003). Subgroup analysis showed the most favorable outcomes for synchronous OMD patients receiving early OMDRT, with a median PFS of 22.2 months and a 5-year survival rate of 42.1%. The treatment of the primary prostate provided a survival benefit in the OS of synchronous OMD patients (5-year 83.1% vs. 50%,p= 0.025), and there was a further improvement in OS after PPR (5-year 87.7% vs. 50%,p= 0.015).Conclusions:Early OMDRT significantly enhances survival outcomes in OMPC, in both synchronous and metachronous cases. The integration of PPR can further improve results, emphasizing the importance of early intervention and personalized treatment strategies. To more definitively clarify our findings across various clinical situations, further studies with larger cohorts or prospective designs are necessary.
背景/目的：寡转移性前列腺癌（OMPC）是转移性疾病的早期阶段，以病灶数量有限为特征。影像学和治疗技术的进步重新激发了人们对个体化治疗的兴趣，包括转移灶定向放疗（OMDRT）和原发前列腺放疗（PPR）。本研究评估了OMDRT时机以及PPR对OMPC患者生存结局的影响。 方法：在这项回顾性队列研究中，分析了2010年至2019年间接受OMDRT的82例OMPC患者。根据OMDRT时机（早期 vs. 晚期）和疾病类型（同步性 vs. 异时性）对患者进行分类。无进展生存期（PFS）和总生存期（OS）为主要终点，通过Kaplan-Meier分析和Cox比例风险模型进行评估。 结果：在患者中，36例（43.9%）为同步性OMD，46例（56.1%）为异时性OMD。中位随访时间为32个月，5年PFS率和OS率分别为77.5%和88.5%。早期OMDRT显著改善了PFS（HR 0.461，95% CI：0.257–0.826，p=0.009）和OS（HR 0.219，95% CI：0.080–0.603，p=0.003）。亚组分析显示，接受早期OMDRT的同步性OMD患者预后最佳，中位PFS为22.2个月，5年生存率为42.1%。原发前列腺治疗为同步性OMD患者的OS带来了生存获益（5年OS率83.1% vs. 50%，p=0.025），并且在PPR后OS有进一步改善（5年OS率87.7% vs. 50%，p=0.015）。 结论：早期OMDRT显著提高了同步性和异时性OMPC患者的生存结局。联合PPR可以进一步改善结果，强调了早期干预和个体化治疗策略的重要性。为了更明确地在各种临床情况下验证我们的发现，需要进行更大规模队列或前瞻性设计的进一步研究。
肿瘤(癌症)患者之家