{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T03:25:34Z","timestamp":1791689134874,"version":"4.3.4"},"reference-count":43,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T00:00:00Z","timestamp":1619481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Metastasis\u2010directed therapy (MDT) utilizing stereotactic body radiotherapy (SBRT) for oligoprogressive lesions could provide a delay in next\u2010line systemic treatment (NEST) change while undergoing androgen receptor\u2010targeted agents (ARTA) treatment. We evaluated prognostic factors for prostate cancer\u2010specific survival (PCSS) and progression\u2010free survival (PFS) to characterize patients receiving treatment with ARTA who may benefit from MDT for oligoprogressive lesions. The impact of MDT on delaying NEST and the predictive factors for NEST\u2010free survival (NEST\u2010FS) were also assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>The clinical data of 54 metastatic castration\u2010resistant prostate cancer patients with 126 oligoprogressive lesions receiving abiraterone (1\u2009g\/day) or enzalutamide (160\u2009mg\/day) before or after systemic chemotherapy were analyzed. A median of three lesions (range: 1\u20135) were treated with MDT. The primary endpoints were PCSS and PFS. The secondary endpoints were time to switch to NEST and NEST\u2010FS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median follow\u2010up time was 19.1\u2009months. Univariate analysis showed that the number of oligoprogressive lesions treated with SBRT and the time between the start of ARTA treatment and oligoprogression were significant prognostic factors for PCSS, and the timing of ARTA treatment (before or after chemotherapy) and the prostate\u2010specific antigen (PSA) response after MDT were significant prognostic factors for PFS. Multivariate analysis showed that early MDT for oligoprogressive lesions delivered less than 6\u2009months after the beginning of ARTA and higher PSA levels after MDT were significant predictors of worse PCSS and PFS. The median total duration of ARTA treatment was 13.8\u2009months. The median time between the start of ARTA treatment and the start of MDT for oligoprogressive lesions was 5.2\u2009months, and MDT extended the ARTA treatment by 8.6\u2009months on average. Thirty\u2010two (59.3%) patients continued ARTA treatment after MDT. ARTA treatment after chemotherapy, early oligoprogression requiring MDT, and lower radiation doses for MDT were independent predictors of NEST\u2010FS in multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>MDT for oligoprogressive lesions is effective and may provide several benefits compared to switching from ARTA treatment to NEST. Patients with early progression while on ARTAs and inadequate PSA responses after MDT have a greater risk of rapid disease progression and poor survival, which necessitates intensified treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.24132","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T23:01:50Z","timestamp":1619564510000},"page":"543-552","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Stereotactic body radiotherapy for oligoprogressive lesions in metastatic castration\u2010resistant prostate cancer patients during abiraterone\/enzalutamide treatment"],"prefix":"10.1002","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2742-9021","authenticated-orcid":false,"given":"Cem","family":"Onal","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Faculty of Medicine, Baskent University Adana Dr. Turgut Noyan Research and Treatment Center  Adana Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatih","family":"Kose","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Faculty of Medicine, Baskent University Adana Dr. Turgut Noyan Research and Treatment Center  Adana Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gokhan","family":"Ozyigit","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Faculty of Medicine Hacettepe University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sercan","family":"Aksoy","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Faculty of Medicine Hacettepe University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezgi","family":"Oymak","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology Iskenderun Gelisim Hospital  Iskenderun Hatay Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadik","family":"Muallaoglu","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology Iskenderun Gelisim Hospital  Iskenderun Hatay Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozan C.","family":"Guler","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Faculty of Medicine, Baskent University Adana Dr. Turgut Noyan Research and Treatment Center  Adana Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burak","family":"Tilki","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Faculty of Medicine Hacettepe University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pervin","family":"Hurmuz","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Faculty of Medicine Hacettepe University  Ankara 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