Radiotherapy for pelvic nodal recurrences after radical prostatectomy: patient selection in clinical practice.

Details

Serval ID
serval:BIB_3425523584B2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Radiotherapy for pelvic nodal recurrences after radical prostatectomy: patient selection in clinical practice.
Journal
Radiation oncology
Author(s)
Panje C., Zilli T., Pra A.D., Arnold W., Brouwer K., Garcia Schüler H.I., Gomez S., Herrera F., Khanfir K., Papachristofilou A., Pesce G., Reuter C., Vees H., Zwahlen D., Putora P.M.
ISSN
1748-717X (Electronic)
ISSN-L
1748-717X
Publication state
Published
Issued date
16/10/2019
Peer-reviewed
Oui
Volume
14
Number
1
Pages
177
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
There is no general consensus on the optimal treatment for prostate cancer (PC) patients with intrapelvic nodal oligorecurrences after radical prostatectomy. Besides androgen deprivation therapy (ADT) as standard of care, both elective nodal radiotherapy (ENRT) and stereotactic body radiotherapy (SBRT) as well as salvage lymph node dissection (sLND) are common treatment options. The aim of our study was to assess decision making and practice patterns for salvage radiotherapy (RT) in this setting.
Treatment recommendations from 14 Swiss radiation oncology centers were collected and converted into decision trees. An iterative process using the objective consensus methodology was applied to assess differences and consensus.
PSMA PET/CT was recommended by 93% of the centers as restaging modality. For unfit patients defined by age, comorbidities or low performance status, androgen deprivation therapy (ADT) alone was recommended by more than 70%. For fit patients with unfavorable tumor characteristics such as short prostate-specific antigen (PSA) doubling time or initial high-risk disease, the majority of the centers (57-71%) recommended ENRT + ADT for 1-4 lesions. For fit patients with favorable tumor characteristics, there were low levels of consensus and a wide variety of recommendations. For 1-4 nodal lesions, focal SBRT was offered by 64% of the centers, most commonly as a 5-fraction course.
As an alternative to ADT, ENRT or SBRT for pelvic nodal oligorecurrences of PC are commonly offered to selected patients, with large treatment variations between centers. The exact number of lymph nodes had a major impact on treatment selection.
Keywords
Decision criteria, Decision making, Nodal recurrence, Oligometastatic, Prostate cancer, Radiotherapy, SBRT
Pubmed
Open Access
Yes
Create date
18/10/2019 16:38
Last modification date
22/10/2019 6:11
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