Nomogram-based risk classification for predicting response to metastasis-directed stereotactic body radiotherapy in PSMA PET-staged oligorecurrent prostate cancer (PORTAL): an international, retrospec
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- #radiotherapy
- #nomogram
- #prostate cancer
- Study developed a nomogram to predict ADT-free survival after metastasis-directed stereotactic body radiotherapy (SBRT) in oligorecurrent prostate cancer.
- Included 586 patients in the development cohort and 131 in the validation cohort, with median follow-ups of 37 and 43 months, respectively.
- Key predictors of earlier ADT initiation: higher pre-MDT PSA, shorter PSA doubling time, 3-5 lesions, and distant metastases.
- ADT-free survival at 1 year was 84.3% in the development cohort and 92.8% in the validation cohort.
- Model discrimination was modest (C-index 0.66 in development, 0.65 in validation), but risk stratification into low, intermediate, and high-risk groups was significant (p<0.0001).
- Nomogram supports treatment selection by identifying patients likely to benefit from metastasis-directed therapy.