TY  - JOUR
A1  - Pinkawa, Michael
A1  - Aebersold, Daniel M.
A1  - Böhmer, Dirk
A1  - Flentje, Michael
A1  - Ghadjar, Pirus
A1  - Schmidt-Hegemann, Nina-Sophie
A1  - Höcht, Stefan
A1  - Hölscher, Tobias
A1  - Müller, Arndt-Christian
A1  - Niehoff, Peter
A1  - Sedlmayer, Felix
A1  - Wolf, Frank
A1  - Zamboglou, Constantinos
A1  - Zips, Daniel
A1  - Wiegel, Thomas
T1  - Radiotherapy in nodal oligorecurrent prostate cancer
JF  - Strahlentherapie und Onkologie
N2  - Objective
The current article encompasses a literature review and recommendations for radiotherapy in nodal oligorecurrent prostate cancer.

Materials and methods
A literature review focused on studies comparing metastasis-directed stereotactic ablative radiotherapy (SABR) vs. external elective nodal radiotherapy (ENRT) and studies analyzing recurrence patterns after local nodal treatment was performed. The DEGRO Prostate Cancer Expert Panel discussed the results and developed treatment recommendations.

Results
Metastasis-directed radiotherapy results in high local control (often > 90% within a follow-up of 1–2 years) and can be used to improve progression-free survival or defer androgen deprivation therapy (ADT) according to prospective randomized phase II data. Distant progression after involved-node SABR only occurs within a few months in the majority of patients. ENRT improves metastases-free survival rates with increased toxicity in comparison to SABR according to retrospective comparative studies. The majority of nodal recurrences after initial local treatment of pelvic nodal metastasis are detected within the true pelvis and common iliac vessels.

Conclusion
ENRT with or without a boost should be preferred to SABR in pelvic nodal recurrences. In oligometastatic prostate cancer with distant (extrapelvic) nodal recurrences, SABR alone can be performed in selected cases. Application of additional systemic treatments should be based on current guidelines, with ADT as first-line treatment for hormone-sensitive prostate cancer. Only in carefully selected patients can radiotherapy be initially used without additional ADT outside of the current standard recommendations. Results of (randomized) prospective studies are needed for definitive recommendations.
KW  - prostate cancer
KW  - oligorecurrence
KW  - metastasis-directed therapy
KW  - radiation therapy
KW  - androgen deprivation therapy
KW  - stereotactic body radiotherapy
KW  - oligmometastases
KW  - lymph node metastases
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-307763
SN  - 0179-7158
SN  - 1439-099X
VL  - 197
IS  - 7
ER  -