# Stereotactic Body Radiation Therapy Without Androgen Deprivation in a 92-Year-Old With Oligometastatic Stage IVA Prostate Cancer: A Case Report

## TL;DR

An elderly man with advanced prostate cancer was successfully treated with radiation alone, avoiding hormone therapy and experiencing minimal side effects.

## Contribution

This case demonstrates that SBRT alone can be a feasible and well-tolerated treatment for select elderly patients with oligometastatic prostate cancer.

## Key findings

- SBRT alone achieved a significant PSA decline from 12.05 to 0.16 ng/ml in six months.
- The patient experienced only Grade 1 urinary toxicity without rectal spacer use.
- SBRT monotherapy was well-tolerated in an elderly patient who declined androgen deprivation therapy.

## Abstract

We report a case of a 92-year-old elderly male with Stage IVA oligometastatic prostate adenocarcinoma to the pelvic nodes managed successfully with stereotactic body radiotherapy (SBRT) alone. The patient declined androgen deprivation therapy (ADT) with concerns about quality of life and reported side effects. He was treated with weekly SBRT targeting the prostate and pelvic lymph nodes without a rectal spacer, experiencing only Grade 1 urinary toxicity. The prostate-specific antigen (PSA) significantly declined from 12.05 to 0.16 ng/ml at the six-month follow-up. This case shows the feasibility and tolerability of SBRT as monotherapy in select elderly patients with regional risk node-positive prostate cancer.