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Stereotactic ablative radiotherapy for the primary site in a patient with nonmetastatic castration-resistant prostate cancer

 Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan

Correspondence Address:
Atsuto Katano,
Department of Radiology, The University of Tokyo Hospital, Tokyo
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jrcr.jrcr_13_22

There is accumulating evidence regarding the efficacy and feasibility of stereotactic ablative radiotherapy (SABR) for localized prostate cancer. We report a case of nonmetastatic castration-resistant prostate cancer (nmCRPC) that was treated with SABR applied to the prostate. A Japanese 83-year-old man was referred to our hospital for a consultation regarding treatment for castration-resistant prostate cancer with an elevated prostate-specific antigen (PSA) level of 13.5 ng/mL. Pelvic magnetic resonance imaging revealed locally advanced cancer with seminal vesicle invasion. Contrast-enhanced computed tomography and bone scintigraphy showed neither nodal nor distant metastases. Consequently, he was diagnosed with nmCRPC. While receiving leuprolide in our hospital, his serum PSA level continued to increase to 16.6 ng/mL. He agreed to undergo SABR, which consisted of 5 fractions, 8 Gy per fraction, delivered every other day excluding weekends, to a total dose of 40 Gy. Six months after initiating SABR, the PSA level decreased to 0.79 ng/mL. Our report suggests that SABR contributes to the suppression of disease progression in patients with nmCRPC. Further studies are needed to determine the clinical benefit of SABR as a local therapy for nmCRPC.

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