{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T08:36:01Z","timestamp":1778315761460,"version":"3.51.4"},"reference-count":37,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T00:00:00Z","timestamp":1691539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background: The favorable role of SBRT for lymph-nodal oligometastases from prostate cancer has been reported by several retrospective and prospective experiences, suggesting a more indolent natural history of disease when compared to patients with bone oligometastases. This retrospective multicenter study evaluates the outcomes of a cohort of patients treated with stereotactic body radiotherapy for lymph-nodal oligometastases. Methods: Inclusion criteria were up to five lymph-nodal oligometastases detected either with Choline-PET or PSMA-PET in patients na\u00efve for ADT or already ongoing with systemic therapy and at least 6 Gy per fraction for SBRT. Only patients with exclusive lymph-nodal disease were included. The primary endpoint of the study was LC; a toxicity assessment was retrospectively performed following CTCAE v4.0. Results: A total of 100 lymph-nodal oligometastases in 69 patients have been treated with SBRT between April 2015 and November 2022. The median age was 73 years (range, 60\u201385). Oligometastatic disease was mainly detected with Choline-PET in 47 cases, while the remaining were diagnosed using PSMA-PET, with most of the patients treated to a single lymph-nodal metastasis (48\/69 cases), two in 14 cases, and three in the remaining cases. The median PSA prior to SBRT was 1.35 ng\/mL (range, 0.3\u201323.7 ng\/mL). Patients received SBRT with a median total dose of 35 Gy (range, 30\u201340 Gy) in a median number of 5 (range, 3\u20136) fractions. With a median follow-up of 16 months (range, 7\u201359 months), our LC rates were 95.8% and 86.3% at 1 and 2 years. DPFS rates were 90.4% and 53.4%, respectively, at 1 and 2 years, with nine patients developing a sequential oligometastatic disease treated with a second course of SBRT. Polymetastatic disease-free survival (PMFS) at 1 and 2 years was 98% and 96%. Six patients needed ADT after SBRT for a median time of ADT-free survival of 15 months (range, 6\u201322 months). The median OS was 16 months (range, 7\u201359) with 1- and 2-year rates of both 98%. In multivariate analysis, higher LC rates and the use of PSMA-PET were related to improved DPFS rates, and OS was significantly related to a lower incidence of distant progression. No G3 or higher adverse events were reported. Conclusions: In our experience, lymph-nodal SBRT for oligometastatic prostate cancer is a safe and effective option for ADT delay with no severe toxicity.<\/jats:p>","DOI":"10.3390\/medicina59081442","type":"journal-article","created":{"date-parts":[[2023,8,9]],"date-time":"2023-08-09T10:08:59Z","timestamp":1691575739000},"page":"1442","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Stereotactic Body Radiotherapy for Lymph-Nodal Oligometastatic Prostate Cancer: A Multicenter Retrospective Experience"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0390-9511","authenticated-orcid":false,"given":"Francesco","family":"Cuccia","sequence":"first","affiliation":[{"name":"Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Tamburo","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, Cannizzaro Hospital, 95100 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2361-9327","authenticated-orcid":false,"given":"Antonio","family":"Piras","sequence":"additional","affiliation":[{"name":"Radioterapia Oncologica, Villa Santa Teresa, 90100 Palermo, Italy"},{"name":"RI.MED Foundation, 90100 Palermo, Italy"},{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Molecular and Clinical Medicine, University of Palermo, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Mortellaro","sequence":"additional","affiliation":[{"name":"Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Iudica","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, AOU Policlinico-VE, 95100 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonino","family":"Daidone","sequence":"additional","affiliation":[{"name":"Radioterapia Oncologica, Villa Santa Teresa, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Federico","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, Casa di Cura Macchiarella, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Zagardo","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, REM Radioterapia, 95100 Viagrande, CT, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2305-5544","authenticated-orcid":false,"given":"Gianluca","family":"Ferini","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, REM Radioterapia, 95100 Viagrande, CT, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Marletta","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, Cannizzaro Hospital, 95100 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corrado","family":"Spatola","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, AOU Policlinico-VE, 95100 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Fazio","sequence":"additional","affiliation":[{"name":"Radiotherapy Unit, Casa di Cura Macchiarella, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Filosto","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, La Maddalena Dipartimento Oncologico di III Livello, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Pergolizzi","sequence":"additional","affiliation":[{"name":"Department of Radiological Science, University of Messina, 98121 Messina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Ferrera","sequence":"additional","affiliation":[{"name":"Radiation Oncology, ARNAS Civico Hospital, 90100 Palermo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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