A European multicenter cohort study of patients with oligometastatic prostate cancer receiving stereotactic body radiotherapy for non-spinal bone metastases

Abstract Purpose Stereotactic body radiotherapy (SBRT) is increasingly used for the treatment of bone metastases (BoM) of oligometastatic prostate cancer. This study aims to provide new information on SBRT for non-spinal BoM of oligometastatic prostate cancer in a large multicenter cohort. Methods Retrospective data from 20 European centers on patients with oligometastatic prostate cancer who received SBRT for BoM between 2010 and 2024 were analyzed to assess patterns of practice, efficacy, safety, and prognosis. Results A total of 317 patients with 401 BoM were analyzed. The SBRT was delivered in 1–10 fractions, with a median fractional dose of 8 Gy (range 4.0–22.0 Gy) and a corresponding total prescribed dose of 18.0–50.0 Gy. Median follow-up was 25.4 months. Local control at 1 and 3 years was 98.0% (95% confidence interval [CI]: 95.2%–99.1%) and 93.3% (95% CI: 88.1%–96.2%). Progression-free survival (PFS) rates after 1 and 3 years were 74.2% (95% CI: 67.5%–79.6%) and 44.1% (95% CI: 36.0%–51.9%). Overall survival (OS) at 1 and 3 years was 98.4% (95% CI: 95.7%–99.4%) and 86.3% (95% CI: 79.4%–91.1%). In multivariable analysis, improved PFS and biochemical recurrence-free survival (BRFS) were observed for higher biologically effective doses with an α/β = 4 Gy (BED 4 ) to the gross tumor volume (GTV) mean (hazard ratio [HR] 0.99; p < 0.01; HR 0.98; p < 0.001) and use of a simultaneous integrated boost (SIB; HR 0.41; p = 0.04; HR 0.40; p < 0.01; respectively). Grade 3 acute and late adverse events were rarely reported (1.0% and 0.5%, respectively). Conclusion Stereotactic body radiotherapy of non-spinal BoM from oligometastatic prostate cancer was an effective and well-tolerated treatment. Higher GTV-BED and the use of an SIB concept were associated with more favorable PFS and BRFS, warranting confirmation in prospective studies and further standardization of target volume and dose prescription concepts.

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Journal
Strahlentherapie und Onkologie
Published
2026-11-03
DOI
https://doi.org/10.1007/s00066-026-02617-x
Primary Topic
Management of metastatic bone disease
Type
article
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article

A European multicenter cohort study of patients with oligometastatic prostate cancer receiving stereotactic body radiotherapy for non-spinal bone metastases

Frank Anton Giordano, Richard Partl, Eleni Gkika, Olaf Wittenstein et al.
Strahlentherapie und Onkologie
Management of metastatic bone disease
article

A European multicenter cohort study of patients with oligometastatic prostate cancer receiving stereotactic body radiotherapy for non-spinal bone metastases

Frank Anton Giordano, Richard Partl, Eleni Gkika, Olaf Wittenstein, Matthias Gückenberger, Kenneth Klischies, Richard Holý, Gabriele Simontacchi, Christos Moustakis, Ahmed Gawish, Yvonne Dzierma, S. A. Schafer, Fabian Lohaus, Oliver Blanck, Jochen Willner, Judit Boda‐Heggemann, Alexander Rühle, Priska Bank, Andrea Baehr, Camilla von Wachter, Panagiotis Balermpas, M Slavík, Arne Grün, Felix Ehret, Thomas Baptist Brunner, Jörg Andreas Müller, Mauro Loi, Nils H. Nicolay, Petr Burkoň, Franziska Nägler, Isabell Seiler, Johannes Meents, Anna Sabrina Schunn, Maike Trommer, Lena Kästner, Sophia Drabke, Thomas Mader
article en

Abstract

Abstract Purpose Stereotactic body radiotherapy (SBRT) is increasingly used for the treatment of bone metastases (BoM) of oligometastatic prostate cancer. This study aims to provide new information on SBRT for non-spinal BoM of oligometastatic prostate cancer in a large multicenter cohort. Methods Retrospective data from 20 European centers on patients with oligometastatic prostate cancer who received SBRT for BoM between 2010 and 2024 were analyzed to assess patterns of practice, efficacy, safety, and prognosis. Results A total of 317 patients with 401 BoM were analyzed. The SBRT was delivered in 1–10 fractions, with a median fractional dose of 8 Gy (range 4.0–22.0 Gy) and a corresponding total prescribed dose of 18.0–50.0 Gy. Median follow-up was 25.4 months. Local control at 1 and 3 years was 98.0% (95% confidence interval [CI]: 95.2%–99.1%) and 93.3% (95% CI: 88.1%–96.2%). Progression-free survival (PFS) rates after 1 and 3 years were 74.2% (95% CI: 67.5%–79.6%) and 44.1% (95% CI: 36.0%–51.9%). Overall survival (OS) at 1 and 3 years was 98.4% (95% CI: 95.7%–99.4%) and 86.3% (95% CI: 79.4%–91.1%). In multivariable analysis, improved PFS and biochemical recurrence-free survival (BRFS) were observed for higher biologically effective doses with an α/β = 4 Gy (BED 4 ) to the gross tumor volume (GTV) mean (hazard ratio [HR] 0.99; p < 0.01; HR 0.98; p < 0.001) and use of a simultaneous integrated boost (SIB; HR 0.41; p = 0.04; HR 0.40; p < 0.01; respectively). Grade 3 acute and late adverse events were rarely reported (1.0% and 0.5%, respectively). Conclusion Stereotactic body radiotherapy of non-spinal BoM from oligometastatic prostate cancer was an effective and well-tolerated treatment. Higher GTV-BED and the use of an SIB concept were associated with more favorable PFS and BRFS, warranting confirmation in prospective studies and further standardization of target volume and dose prescription concepts.

Strahlentherapie und Onkologie
University of Bonn (DE), German Cancer Research Center (DE), Medical University of Graz (AT), Masaryk University (CZ), Heidelberg University (DE), Universitätsklinikum Gießen und Marburg (DE), University Hospital Bonn (DE), Helmholtz-Zentrum Dresden-Rossendorf (DE), Bayreuth Medical Center (DE), Humboldt-Universität zu Berlin (DE), University Medical Center of the Johannes Gutenberg University Mainz (DE), SRH Wald-Klinikum Gera (DE), University Hospital of Zurich (CH), German Cancer Society (DE), University Medical Center Hamburg-Eppendorf (DE), University Hospital Schleswig-Holstein (DE), Masaryk Memorial Cancer Institute (CZ), Azienda Ospedaliero-Universitaria Careggi (IT), Universitätsklinikum Aachen (DE), University Hospital Leipzig (DE), German Centre for Cardiovascular Research (DE), Universitätsmedizin Rostock (DE), Kantonsspital Graubünden (CH), University Hospital in Halle (DE), University Hospital Cologne (DE), University Medical Centre Mannheim (DE), University Hospital Carl Gustav Carus (DE), Nationales Centrum für Tumorerkrankungen Dresden (DE), Medizinische Fakultät Mannheim (DE), German Cancer Consortium (DKTK) Dresden (DE), University of Florence (IT), Freie Universität Berlin (DE), Technische Universität Dresden (DE), Charité - Universitätsmedizin Berlin (DE), FH Aachen (DE)
Openalex Percentile: Top 11%
Management of metastatic bone disease
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