The role of stereotactic body radiotherapy in oligoprogressive prostate cancer: A site-specific analysis of the prospective, phase II RADIANT trial

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dc.contributor.authorRuicci, Kara M.en
dc.contributor.authorBarry, Aislingen
dc.contributor.authorYe, Xiang Y.en
dc.contributor.authorChung, Peter W.en
dc.contributor.authorBerlin, Alejandroen
dc.contributor.authorCatton, Charlesen
dc.contributor.authorGutierrez, Enriqueen
dc.contributor.authorMesci, Aruzen
dc.contributor.authorMcPartlin, Andrewen
dc.contributor.authorRaman, Srinivasen
dc.contributor.authorWinter, Jeffen
dc.contributor.authorDang, Jenniferen
dc.contributor.authorFallah-Rad, Nazaninen
dc.contributor.authorKumar, Vikaashen
dc.contributor.authorJiang, Di Mariaen
dc.contributor.authorSridhar, Srikalaen
dc.contributor.authorHelou, Joelleen
dc.contributor.authorGlicksman, Rachel M.en
dc.date.accessioned2025-07-22T10:59:35Z
dc.date.available2025-07-22T10:59:35Z
dc.date.issued2025-07-08en
dc.description.abstractBackground and Purpose: Changing to next-line systemic therapy is the standard-of-care for patients with progressive metastatic castrate-resistant prostate cancer. However, to preserve systemic therapy options and minimize toxicity, stereotactic body radiation therapy (SBRT) is being increasingly considered for patients with limited disease progression (‘oligoprogression’). Herein, we report clinical, toxicity and quality of life (QOL) outcomes for an oligoprogressive prostate cancer cohort from a prospective trial. Materials and methods: RADIANT (NCT04122469) was a single-arm, phase-II basket trial which included patients with metastatic prostate cancer on any systemic therapy ≥ 3 months, with radiographic evidence of oligoprogression in ≤ 5 sites. Analysis by disease site was planned a priori. Patients received SBRT in 1–5 fractions to all progressive sites and were maintained on their current systemic therapy. The primary endpoint was cumulative incidence of change in systemic therapy. Key secondary endpoints included local control, toxicity and health-related (HR) QOL. Results: Thirty-two patients were analyzed; median age was 74.0 years, median PSA 6.7 µg/L, 25% with visceral metastases and a median of 2 prior systemic therapy lines. Median follow-up was 14.1 months (range 4.8–51.9 months). At 1-year, 55.1% of patients remained on the same systemic line and local control was 84.0%. The cumulative incidence of grade 2 toxicity was 25.0% at 1 year, with no grade 3+ toxicities. HRQOL was maintained, with no detriment following SBRT delivery. Conclusion: Among patients with oligoprogressive prostate cancer, SBRT is an effective and safe intervention, including in patients with aggressive clinicopathologic features. Larger, randomized trials are needed to validate these findings.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid111041en
dc.identifier.citationRuicci, K. M., Barry, A., Xiang, Y. Y., Chung, P. W., Berlin, A., Catton, C., Gutierrez, E., Mesci, A., McPartlin, A., Raman, S. and Winter, J. (2025) 'The role of stereotactic body radiotherapy in oligoprogressive prostate cancer: A site-specific analysis of the prospective, phase II RADIANT trial', Radiotherapy and Oncology, 210, 111041 (8pp). https://doi.org/10.1016/j.radonc.2025.111041en
dc.identifier.doi10.1016/j.radonc.2025.111041en
dc.identifier.endpage8en
dc.identifier.issn1678140en
dc.identifier.journaltitleRadiotherapy and Oncologyen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/17737
dc.identifier.volume210
dc.language.isoenen
dc.publisherElsevier Ireland Ltden
dc.rights© 2025, the Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/)en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectClinical trialen
dc.subjectDrug therapyen
dc.subjectMetastasisen
dc.subjectProstate canceren
dc.subjectRadiationen
dc.titleThe role of stereotactic body radiotherapy in oligoprogressive prostate cancer: A site-specific analysis of the prospective, phase II RADIANT trialen
dc.typeArticle (peer reviewed)en
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