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

Détails

ID Serval
serval:BIB_3425523584B2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Radiotherapy for pelvic nodal recurrences after radical prostatectomy: patient selection in clinical practice.
Périodique
Radiation oncology
Auteur(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
Statut éditorial
Publié
Date de publication
16/10/2019
Peer-reviewed
Oui
Volume
14
Numéro
1
Pages
177
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
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.
Mots-clé
Decision criteria, Decision making, Nodal recurrence, Oligometastatic, Prostate cancer, Radiotherapy, SBRT
Pubmed
Open Access
Oui
Création de la notice
18/10/2019 15:38
Dernière modification de la notice
22/10/2019 5:11
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