ArticleFrontiers in urology2026
Bridging to systemic therapy: PSMA-PET-based early and repetitive stereotactic body radiotherapy for nodal and bone oligo-recurrent prostate cancer.
Article in Frontiers in urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: To provide a detailed analysis regarding survival, local control and toxicity of nodal/bone oligo-recurrent prostate cancer identified and treated with PSMA-PET/CT and robotic SBRT using a uniform dose/fractionation scheme. The use of ADT was excluded. Methods: Retrospective analysis of patients with initial high-risk factors presenting with nodal/bone oligo-recurrent PCA in Ga68- or F18-PSMA-PET/CT treated with 1-3 fraction robotic SBRT. Results: 60 patients/172 metastases were treated in 95 treatment series with 43 patients receiving >1 SBRT course. Median FU was 22 months. bPFS/SBRT-FS/ADT-FS was 6/23/32 months at 89.7% local control and 6.5/1.1% acute/late grade 1 AE. High PSA-nadir, initial pN1-status and longer time to PSA-nadir were predictive for worse bPFS/SBRT-FS. Discussion: Metastasis-Directed-Therapy using ablative focal SBRT is effective in bridging the gap between the identification of early metastases and the initiation of palliative systemic therapy. It is a fast outpatient procedure yielding high rates of local control, free of significant toxicity and repeatable if necessary. ADT could be withheld for almost 3 years. Patients with predictors for worse outcome could be identified.
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