Salvage radiotherapy for macroscopic local recurrences after radical prostatectomy : A national survey on patterns of practice.

Dal Pra, Alan; Panje, Cedric; Zilli, Thomas; Arnold, Winfried; Brouwer, Kathrin; Garcia, Helena; Glatzer, Markus; Gomez, Silvia; Herrera, Fernanda; Kaouthar, Khanfir; Papachristofilou, Alexandros; Pesce, Gianfranco; Reuter, Christiane; Vees, Hansjörg; Zwahlen, Daniel Rudolf; Engeler, Daniel; Putora, Paul Martin (2018). Salvage radiotherapy for macroscopic local recurrences after radical prostatectomy : A national survey on patterns of practice. Strahlentherapie und Onkologie, 194(1), pp. 9-16. Springer-Medizin-Verlag 10.1007/s00066-017-1172-3

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INTRODUCTION Although salvage radiotherapy (SRT) for PSA recurrence after radical prostatectomy provides better oncological outcomes when delivered early, in the absence of detectable disease many patients are treated for macroscopic locally recurrent tumors. Due to limited data from prospective studies, we hypothesized an important variability in the SRT management of these patients. Our aim was to investigate current practice patterns of SRT for local macroscopic recurrence after radical prostatectomy. MATERIAL AND METHODS A total of 14 Swiss radiation oncology centers were asked to complete a survey on treatment specifications for macroscopic locally recurrent disease including information on pretherapeutic diagnostic procedures, dose prescription, radiation delivery techniques and androgen deprivation therapy (ADT). Treatment recommendations on ADT were analyzed using the objective consensus methodology. RESULTS The majority of centers recommended pretreatment magnetic resonance imaging (MRI) of the pelvis and choline positron emission tomography (PET). The median prescribed dose to the prostate bed was 66 Gy (range 65-72 Gy) with a boost to the macroscopic lesion used by 79% of the centers with a median total dose of 72 Gy (range 70-80 Gy). Intensity-modulated rotational techniques were used by all centers and daily cone beam computed tomography (CT) was recommended by 43%. The use of concomitant ADT for any macroscopic recurrence was recommended by 43% of the centers while the remaining centers recommended it only for high-risk disease, which was not consistently defined. CONCLUSION We observed a high variability of treatment paradigms when SRT is indicated for macroscopic local recurrences after prostatectomy. These data reflect the need for more standardized approaches and ultimately further research in this field.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Dal Pra, Alan and Putora, Paul Martin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0179-7158

Publisher:

Springer-Medizin-Verlag

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

06 Apr 2018 10:51

Last Modified:

30 Oct 2019 19:07

Publisher DOI:

10.1007/s00066-017-1172-3

PubMed ID:

28656373

Uncontrolled Keywords:

Macroscopic recurrence Postoperative radiotherapy Prostate cancer Radiotherapy Salvage radiotherapy

BORIS DOI:

10.7892/boris.105283

URI:

https://boris.unibe.ch/id/eprint/105283

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