Articles

Traveling the prostate cancer timeline in chase of treatment paradigms: Can we cure the incurable?

BJMO - volume 16, issue 7, november 2022

C. Berghen MD, PhD, S. Joniau MD, PhD, K. Rans MD, G. De Meerleer MD, PhD

SUMMARY

When prostate cancer (PCa) patients are diagnosed as ‘incurable’, most patients still have many years to live and often undergo a continuum of burdensome and expensive systemic treatments that can impair quality of life. Due to the active promotion of new systemic therapies in the treatment of metastatic and/or castrationrefractory PCa patients, other treatment modalities such as modern radiotherapy (RT) have been considered as therapies that relieve symptoms, without offering any possibility of cure or additional quality of life-adjusted life years. This PhD thesis investigated whether the implementation of modern RT in previously non-RT indications could prove otherwise. To achieve this, the PCa timeline was followed in search of treatment paradigms, and re-introduced RT in different disease settings. Firstly, the addition of elective para-aortic lymph node radiotherapy was investigated in patients diagnosed with locally advanced pN1 prostate cancer, with local treatment of the prostate (bed) and pelvic lymph nodes, along with 24 months of ADT, in the prospective multicentric PART study. Secondly, a large retrospective study was performed, focused on patients with oligorecurrent prostate cancer who were treated with metastasis-directed therapy (MDT). Finally, the use of MDT was investigated in patients diagnosed with oligoprogressive metastatic castration-resistant prostate cancer (mCRPC), while continuing otherwise successful ongoing systemic treatment. Will this approach lead to a substantial postponement of next-line systemic treatment (NEST)?

(BELG J MED ONCOL 2022;16(7):363–6)

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Repeated stereotactic body radiotherapy (SBRT) in a patient presenting with oligometastatic prostate cancer while treated with anti-androgens: a case report

BJMO - volume 15, issue 6, october 2021

S. Allaert , M. Bangia , K. Rans MD, C. Berghen MD, PhD, S. Joniau MD, PhD, G. Devos MD, PhD, H. Dumez MD, PhD, S. Jentjens MD, PhD, G. De Meerleer MD, PhD

SUMMARY

This case report of an 80-year-old patient, who presented with up to six manifestations of oligorecurrent prostate cancer (PCa) over a time period of nine years, shows that repeated treatment with metastasis directed therapy (MDT) in this setting is feasible and nearly atoxic.

(BELG J MED ONCOL 2021;15(6):325-30)

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