Background: Mismatch-repair-deficiency resulting in microsatellite instability (MSI) may confer increased radiosensitivity in locally advanced/metastatic tumors and thus radiotherapy (RT) potentially might have a changing role in treating this subset of patients, alone or in combination with checkpoint inhibitors. Case presentation: We report a 76 year-old Italian male patient presenting with locally advanced undifferentiated prostate cancer (LAPC), infiltrating bladder and rectum. Molecular analysis revealed high-MSI with an altered expression of MSH2 and MSH6 at immunohistochemistry. Two months after 6 chemotherapy cycles with Docetaxel associated to an LHRH analogue, a computed tomography scan showed stable disease. After palliative RT (30 Gy/10 fractions) directed to the tumor mass with a 3D-conformal setup, a follow-up computed tomography scan at 8 weeks revealed an impressive response that remained stable at computed tomography after 9 months, with sustained biochemical response. To our knowledge, this is the first case of such a sustained response to low dose RT alone in high-MSI LAPC. Conclusions: Routine evaluation of MSI in patients with locally problematic advanced tumors might change treatment strategy and treatment aim in this setting, from a purely palliative approach to a quasi-curative paradigm.

Unexpected tumor response to palliative pelvic radiotherapy in mismatch repair-deficient advanced prostate cancer: a case report / Aluisio, Giovanni; Mazzeo, Ercole; Lohr, Frank; Fiocchi, Federica; Bettelli, Stefania; Baldessari, Cinzia; Paterlini, Maurizio; Bruni, Alessio. - In: JOURNAL OF MEDICAL CASE REPORTS. - ISSN 1752-1947. - 14:1(2020), p. 239. [10.1186/s13256-020-02578-4]

Unexpected tumor response to palliative pelvic radiotherapy in mismatch repair-deficient advanced prostate cancer: a case report

Lohr, Frank;
2020-01-01

Abstract

Background: Mismatch-repair-deficiency resulting in microsatellite instability (MSI) may confer increased radiosensitivity in locally advanced/metastatic tumors and thus radiotherapy (RT) potentially might have a changing role in treating this subset of patients, alone or in combination with checkpoint inhibitors. Case presentation: We report a 76 year-old Italian male patient presenting with locally advanced undifferentiated prostate cancer (LAPC), infiltrating bladder and rectum. Molecular analysis revealed high-MSI with an altered expression of MSH2 and MSH6 at immunohistochemistry. Two months after 6 chemotherapy cycles with Docetaxel associated to an LHRH analogue, a computed tomography scan showed stable disease. After palliative RT (30 Gy/10 fractions) directed to the tumor mass with a 3D-conformal setup, a follow-up computed tomography scan at 8 weeks revealed an impressive response that remained stable at computed tomography after 9 months, with sustained biochemical response. To our knowledge, this is the first case of such a sustained response to low dose RT alone in high-MSI LAPC. Conclusions: Routine evaluation of MSI in patients with locally problematic advanced tumors might change treatment strategy and treatment aim in this setting, from a purely palliative approach to a quasi-curative paradigm.
2020
1
Aluisio, Giovanni; Mazzeo, Ercole; Lohr, Frank; Fiocchi, Federica; Bettelli, Stefania; Baldessari, Cinzia; Paterlini, Maurizio; Bruni, Alessio...espandi
Unexpected tumor response to palliative pelvic radiotherapy in mismatch repair-deficient advanced prostate cancer: a case report / Aluisio, Giovanni; Mazzeo, Ercole; Lohr, Frank; Fiocchi, Federica; Bettelli, Stefania; Baldessari, Cinzia; Paterlini, Maurizio; Bruni, Alessio. - In: JOURNAL OF MEDICAL CASE REPORTS. - ISSN 1752-1947. - 14:1(2020), p. 239. [10.1186/s13256-020-02578-4]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11572/403151
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