Salvage-Radiotherapie bei makroskopischen Lokalrezidiven nach radikaler Prostatektomie : Nationale Umfrage zu Behandlungsmustern [Salvage radiotherapy for macroscopic local recurrences after radical prostatectomy : A national survey on patterns of practice]

Details

Serval ID
serval:BIB_65346354F1F9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Salvage-Radiotherapie bei makroskopischen Lokalrezidiven nach radikaler Prostatektomie : Nationale Umfrage zu Behandlungsmustern [Salvage radiotherapy for macroscopic local recurrences after radical prostatectomy : A national survey on patterns of practice]
Journal
Strahlentherapie und Onkologie
Author(s)
Dal Pra A., Panje C., Zilli T., Arnold W., Brouwer K., Garcia H., Glatzer M., Gomez S., Herrera F., Kaouthar K., Papachristofilou A., Pesce G., Reuter C., Vees H., Zwahlen D.R., Engeler D., Putora P.M.
ISSN
1439-099X (Electronic)
ISSN-L
0179-7158
Publication state
Published
Issued date
01/2018
Peer-reviewed
Oui
Volume
194
Number
1
Pages
9-16
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
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.
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.
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.
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.
Keywords
Humans, Magnetic Resonance Imaging, Male, Neoplasm Recurrence, Local/pathology, Neoplasm Recurrence, Local/radiotherapy, Neoplasm Recurrence, Local/surgery, Positron-Emission Tomography, Postoperative Complications/radiotherapy, Postoperative Complications/surgery, Practice Patterns, Physicians', Prostatectomy, Prostatic Neoplasms/pathology, Prostatic Neoplasms/radiotherapy, Prostatic Neoplasms/surgery, Radiotherapy Dosage, Salvage Therapy, Switzerland, Macroscopic recurrence, Postoperative radiotherapy, Prostate cancer, Radiotherapy, Salvage radiotherapy
Pubmed
Web of science
Create date
06/07/2017 17:33
Last modification date
05/12/2019 18:27
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