Skip to main content
Erschienen in: Clinical and Translational Oncology 9/2016

30.11.2015 | Research Article

Management of prostate cancer patients following radiation therapy after radical surgery referred from urology to radiation oncology departments in Spain

verfasst von: A. Gómez Caamaño, A. Zapatero, J. López Torrecilla, X. Maldonado

Erschienen in: Clinical and Translational Oncology | Ausgabe 9/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To define usual clinical management of prostate cancer (PCa) patients following postoperative radiation therapy (RT) (adjuvant or salvage) and its evolution over time in radiation oncology (RO) departments in Spain.

Methods

An epidemiological, cross-sectional, multicentre study was conducted. 567 PCa patients that had undergone radical prostatectomy (RP) and received postoperative RT between February and December of both 2006 and 2011 participated in the study. In patients from 2006, health-related quality of life (HRQoL) was assessed using the EPIC questionnaire. Investigators completed a specific survey on two clinical cases of adjuvant and salvage RT.

Results

70.6 % of patients received salvage RT versus 29.4 % who received adjuvant RT; no significant differences were found in terms of frequency for each procedure between both the years. Regarding the survey, a positive surgical margin was the main criteria used in adjuvant RT decision making. In terms of salvage RT scenario, 85.7 % of the investigators stated that adjuvant RT should have been offered instead, 81.4 % of the investigators agreed on a PSA score >0.2 ng/mL as the main criteria for identifying biochemical recurrence after RP, and 67.4 % of investigators did not consider any PSA score for ruling out salvage RT treatment.

Conclusions

Most patients are referred to RO departments to receive salvage RT. Despite the publication of three IA evidence level randomized clinical trials, the patterns for using adjuvant and salvage RT did not change from 2006 to 2011, although patients’ profile did. A consensus regarding postoperative RT indications should be reached in order to correct this controversial situation.
Literatur
1.
Zurück zum Zitat Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49:1374–403.CrossRefPubMed Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, Rosso S, Coebergh JW, Comber H, et al. Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer. 2013;49:1374–403.CrossRefPubMed
2.
Zurück zum Zitat Cózar JM, Miñana B, Gómez-Veiga F, Rodríguez-Antolín A, Villavicencio H, Cantalapiedra A, et al. Registro nacional de cáncer de próstata 2010 en España. Actas Urol Esp. 2013;37:12–9.PubMed Cózar JM, Miñana B, Gómez-Veiga F, Rodríguez-Antolín A, Villavicencio H, Cantalapiedra A, et al. Registro nacional de cáncer de próstata 2010 en España. Actas Urol Esp. 2013;37:12–9.PubMed
3.
Zurück zum Zitat Reis LO, Sasse AD, Matheus WE, Denardi F, Stopiglia RM, da Silva MM, et al. Cáncer de próstata: práctica clínica basada en la evidencia. Actas Urol Esp. 2009;33:344–50.CrossRefPubMed Reis LO, Sasse AD, Matheus WE, Denardi F, Stopiglia RM, da Silva MM, et al. Cáncer de próstata: práctica clínica basada en la evidencia. Actas Urol Esp. 2009;33:344–50.CrossRefPubMed
4.
Zurück zum Zitat Bottke D, de Reijke TM, Bartkowiak D, Wiegel T. Salvage radiotherapy in patients with persisting/rising PSA after radical prostatectomy for prostate cancer. Eur J Cancer. 2009;45:148–57.CrossRefPubMed Bottke D, de Reijke TM, Bartkowiak D, Wiegel T. Salvage radiotherapy in patients with persisting/rising PSA after radical prostatectomy for prostate cancer. Eur J Cancer. 2009;45:148–57.CrossRefPubMed
5.
Zurück zum Zitat Thompson IM, Valicenti RK, Albertsen P, Davis BJ, Goldenberg SL, Hahn C, et al. Adjuvant and salvage radiotherapy after prostatectomy: AUA/ASTRO Guideline. J Urol. 2013;190:441–9.CrossRefPubMed Thompson IM, Valicenti RK, Albertsen P, Davis BJ, Goldenberg SL, Hahn C, et al. Adjuvant and salvage radiotherapy after prostatectomy: AUA/ASTRO Guideline. J Urol. 2013;190:441–9.CrossRefPubMed
6.
Zurück zum Zitat Mengual-Cloquell JL, Escolar-Pérez PP, Casaña-Giner M, Chust-Vicente ML, Guinot-Rodríguez JL, Arribas-Alpuente L. Tratamiento adyuvante y de rescate tras prostatectomia radical. Actas Urol Esp. 2005;29:553–61.CrossRefPubMed Mengual-Cloquell JL, Escolar-Pérez PP, Casaña-Giner M, Chust-Vicente ML, Guinot-Rodríguez JL, Arribas-Alpuente L. Tratamiento adyuvante y de rescate tras prostatectomia radical. Actas Urol Esp. 2005;29:553–61.CrossRefPubMed
7.
Zurück zum Zitat Pasquier D, Ballereau C. Adjuvant and salvage radiotherapy after prostatectomy for prostate cancer: a literature review. Int J Radial Oncol Biol Phys. 2008;72:972–9.CrossRef Pasquier D, Ballereau C. Adjuvant and salvage radiotherapy after prostatectomy for prostate cancer: a literature review. Int J Radial Oncol Biol Phys. 2008;72:972–9.CrossRef
8.
Zurück zum Zitat Bolla M, van Poppel H, Collette L, van Cangh P, Vekemans K, Da Pozzo L, et al. Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC Trial 22911). Lancet. 2005;366:572–8.CrossRefPubMed Bolla M, van Poppel H, Collette L, van Cangh P, Vekemans K, Da Pozzo L, et al. Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC Trial 22911). Lancet. 2005;366:572–8.CrossRefPubMed
9.
Zurück zum Zitat Thompson IM Jr, Tangen CM, Paradelo J, Lucia MS, Miller G, Troyer D, et al. Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial. JAMA. 2006;15(296):2329–35.CrossRef Thompson IM Jr, Tangen CM, Paradelo J, Lucia MS, Miller G, Troyer D, et al. Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial. JAMA. 2006;15(296):2329–35.CrossRef
10.
Zurück zum Zitat Thompson IM, Tangen CM, Paradelo J, Lucia MS, Miller G, Troyer D, et al. Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term follow up of a randomized clinical trial. J Urol. 2009;181:956–62.CrossRefPubMedPubMedCentral Thompson IM, Tangen CM, Paradelo J, Lucia MS, Miller G, Troyer D, et al. Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term follow up of a randomized clinical trial. J Urol. 2009;181:956–62.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Wiegel T, Bottke D, Steiner U, Siegmann A, Golz R, Störkel S, et al. Phase III postoperative adjuvant radiotherapy after radical prostatectomy compared with radical prostatectomy alone in pT3 prostate cancer with postoperative undetectable prostate-specific antigen: ARO 96-02/AUO AP 09/95. J Clin Oncol. 2009;27:2924–30.CrossRefPubMed Wiegel T, Bottke D, Steiner U, Siegmann A, Golz R, Störkel S, et al. Phase III postoperative adjuvant radiotherapy after radical prostatectomy compared with radical prostatectomy alone in pT3 prostate cancer with postoperative undetectable prostate-specific antigen: ARO 96-02/AUO AP 09/95. J Clin Oncol. 2009;27:2924–30.CrossRefPubMed
12.
Zurück zum Zitat Stephenson AJ, Scardino PT, Kattan MW, Pisansky TM, Slawin KM, Klein EA, et al. Predicting the outcome of salvage radiation therapy for recurrent prostate cancer after radical prostatectomy. J Clin Oncol. 2007;25:2035–41.CrossRefPubMedPubMedCentral Stephenson AJ, Scardino PT, Kattan MW, Pisansky TM, Slawin KM, Klein EA, et al. Predicting the outcome of salvage radiation therapy for recurrent prostate cancer after radical prostatectomy. J Clin Oncol. 2007;25:2035–41.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Stephenson AJ, Shariat SF, Zelefsky MJ, Kattan MW, Butler EB, Teh BS, et al. Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. JAMA. 2004;291:1325–32.CrossRefPubMed Stephenson AJ, Shariat SF, Zelefsky MJ, Kattan MW, Butler EB, Teh BS, et al. Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy. JAMA. 2004;291:1325–32.CrossRefPubMed
14.
Zurück zum Zitat López Torrecilla J, Zapatero A, Herruzo I, Calvo FA, Cabeza MA, Palacios A, et al. Infrastructures, treatment modalities, and workload of radiation oncology departments in Spain with special attention to prostate cancer. Clin Transl Oncol. 2014;16:447–54.CrossRefPubMed López Torrecilla J, Zapatero A, Herruzo I, Calvo FA, Cabeza MA, Palacios A, et al. Infrastructures, treatment modalities, and workload of radiation oncology departments in Spain with special attention to prostate cancer. Clin Transl Oncol. 2014;16:447–54.CrossRefPubMed
15.
Zurück zum Zitat Chang P, Szymanski KM, Dunn RL, Chipman JJ, Litwin MS, Nguyen PL, et al. Expanded prostate cancer index composite for clinical practice: development and validation of a practical health related quality of life instrument for use in the routine clinical care of patients with prostate cancer. J Urol. 2011;186:865–72.CrossRefPubMed Chang P, Szymanski KM, Dunn RL, Chipman JJ, Litwin MS, Nguyen PL, et al. Expanded prostate cancer index composite for clinical practice: development and validation of a practical health related quality of life instrument for use in the routine clinical care of patients with prostate cancer. J Urol. 2011;186:865–72.CrossRefPubMed
16.
Zurück zum Zitat Mohler J, Bahnson RR, Boston B, Busby JE, D’Amico A, Eastham JA, et al. NCCN clinical practice guidelines in oncology: prostate cancer. J Natl Compr Canc Netw. 2010;8:162–200.PubMed Mohler J, Bahnson RR, Boston B, Busby JE, D’Amico A, Eastham JA, et al. NCCN clinical practice guidelines in oncology: prostate cancer. J Natl Compr Canc Netw. 2010;8:162–200.PubMed
17.
Zurück zum Zitat Lavallée LT, Fergusson D, Mallick R, Grenon R, Morgan SC, Momoli F, et al. Radiotherapy after radical prostatectomy: treatment recommendations differ between urologists and radiation oncologists. PLoS One. 2013;8:e79773.CrossRefPubMedPubMedCentral Lavallée LT, Fergusson D, Mallick R, Grenon R, Morgan SC, Momoli F, et al. Radiotherapy after radical prostatectomy: treatment recommendations differ between urologists and radiation oncologists. PLoS One. 2013;8:e79773.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Showalter TN, Ohri N, Teti KG, Foley KA, Keith SW, Trabulsi EJ, et al. Physician beliefs and practices for adjuvant and salvage radiation therapy after prostatectomy. Int J Radiat Oncol Biol Phys. 2012;82:e233–8.CrossRefPubMed Showalter TN, Ohri N, Teti KG, Foley KA, Keith SW, Trabulsi EJ, et al. Physician beliefs and practices for adjuvant and salvage radiation therapy after prostatectomy. Int J Radiat Oncol Biol Phys. 2012;82:e233–8.CrossRefPubMed
19.
Zurück zum Zitat Valicenti RK, Thompson I Jr, Albertsen P, Davis BJ, Goldenberg SL, Wolf JS, et al. Adjuvant and salvage radiation therapy after prostatectomy: American Society for Radiation Oncology/American Urological Association guidelines. Int J Radiat Oncol Biol Phys. 2013;86:822–8.CrossRefPubMed Valicenti RK, Thompson I Jr, Albertsen P, Davis BJ, Goldenberg SL, Wolf JS, et al. Adjuvant and salvage radiation therapy after prostatectomy: American Society for Radiation Oncology/American Urological Association guidelines. Int J Radiat Oncol Biol Phys. 2013;86:822–8.CrossRefPubMed
20.
Zurück zum Zitat Sofer M, Hamilton-Nelson KL, Schlesselman JJ, Soloway MS. Risk of positive margins and biochemical recurrence in relation to nerve-sparing radical prostatectomy. J Clin Oncol. 2002;20:1853–8.CrossRefPubMed Sofer M, Hamilton-Nelson KL, Schlesselman JJ, Soloway MS. Risk of positive margins and biochemical recurrence in relation to nerve-sparing radical prostatectomy. J Clin Oncol. 2002;20:1853–8.CrossRefPubMed
21.
Zurück zum Zitat Quon H, Suderman D, Guilbert K, Lambert P, Bucher O, Ong A, et al. Population-based referrals for adjuvant radiotherapy after radical prostatectomy in men with prostate cancer: impact of randomized trials. Clin Genitourin Cancer. 2014;12:e1–5.CrossRefPubMed Quon H, Suderman D, Guilbert K, Lambert P, Bucher O, Ong A, et al. Population-based referrals for adjuvant radiotherapy after radical prostatectomy in men with prostate cancer: impact of randomized trials. Clin Genitourin Cancer. 2014;12:e1–5.CrossRefPubMed
22.
Zurück zum Zitat Hoffman KE, Nguyen PL, Chen MH, Chen RC, Choueiri TK, Hu JC, et al. Recommendations for post-prostatectomy radiation therapy in the United States before and after the presentation of randomized trials. J Urol. 2011;185:116–20.CrossRefPubMed Hoffman KE, Nguyen PL, Chen MH, Chen RC, Choueiri TK, Hu JC, et al. Recommendations for post-prostatectomy radiation therapy in the United States before and after the presentation of randomized trials. J Urol. 2011;185:116–20.CrossRefPubMed
24.
Zurück zum Zitat De Torres MV, Álvarez A, Ibáñez C, Caballero B, Ludeña B, Caballero P. Radioterapia adyuvante después de prostatectomía radical como tratamiento preventivo de la recidiva bioquímica. Arch Esp Urol. 2012;65:122–30. De Torres MV, Álvarez A, Ibáñez C, Caballero B, Ludeña B, Caballero P. Radioterapia adyuvante después de prostatectomía radical como tratamiento preventivo de la recidiva bioquímica. Arch Esp Urol. 2012;65:122–30.
25.
Zurück zum Zitat Chen C, Lin T, Zhou Y, Li D, Xu K, Li Z, et al. Adjuvant and salvage radiotherapy after prostatectomy: a systematic review and meta-analysis. PLoS One. 2014;9:e104918.CrossRefPubMedPubMedCentral Chen C, Lin T, Zhou Y, Li D, Xu K, Li Z, et al. Adjuvant and salvage radiotherapy after prostatectomy: a systematic review and meta-analysis. PLoS One. 2014;9:e104918.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat King CR, Kapp DS. Radiotherapy after prostatectomy: is the evidence for dose escalation out there? Int J Radiat Oncol Biol Phys. 2008;71:346–50.CrossRefPubMed King CR, Kapp DS. Radiotherapy after prostatectomy: is the evidence for dose escalation out there? Int J Radiat Oncol Biol Phys. 2008;71:346–50.CrossRefPubMed
27.
Zurück zum Zitat King CR. The timing of salvage radiotherapy after radical prostatectomy: a systematic review. Int J Radiat Oncol Biol Phys. 2012;84:104–11.CrossRefPubMed King CR. The timing of salvage radiotherapy after radical prostatectomy: a systematic review. Int J Radiat Oncol Biol Phys. 2012;84:104–11.CrossRefPubMed
28.
Zurück zum Zitat Parker C, Sydes MR, Catton C, Kynaston H, Logue J, Murphy C, et al. Radiotherapy and androgen deprivation in combination after local surgery (RADICALS): a new Medical Research Council/National Cancer Institute of Canada phase III trial of adjuvant treatment after radical prostatectomy. BJU Int. 2007;99:1376–9.CrossRefPubMed Parker C, Sydes MR, Catton C, Kynaston H, Logue J, Murphy C, et al. Radiotherapy and androgen deprivation in combination after local surgery (RADICALS): a new Medical Research Council/National Cancer Institute of Canada phase III trial of adjuvant treatment after radical prostatectomy. BJU Int. 2007;99:1376–9.CrossRefPubMed
29.
Zurück zum Zitat Pearse M, Fraser-Browne C, Davis ID, Duchesne GM, Fisher R, Frydenberg M, et al. A phase III trial to investigate the timing of radiotherapy for prostate cancer with high-risk features: background and rationale of the Radiotherapy—Adjuvant Versus Early Salvage (RAVES) trial. BJU Int. 2014;113:S7–12.CrossRef Pearse M, Fraser-Browne C, Davis ID, Duchesne GM, Fisher R, Frydenberg M, et al. A phase III trial to investigate the timing of radiotherapy for prostate cancer with high-risk features: background and rationale of the Radiotherapy—Adjuvant Versus Early Salvage (RAVES) trial. BJU Int. 2014;113:S7–12.CrossRef
30.
Zurück zum Zitat Sowerby RJ, Gani J, Yim H, Radomski S, Catton C. Long-term complications in men who have early or late radiotherapy after radical prostatectomy. Can Urol Assoc J. 2014;8:253–8.CrossRefPubMedPubMedCentral Sowerby RJ, Gani J, Yim H, Radomski S, Catton C. Long-term complications in men who have early or late radiotherapy after radical prostatectomy. Can Urol Assoc J. 2014;8:253–8.CrossRefPubMedPubMedCentral
Metadaten
Titel
Management of prostate cancer patients following radiation therapy after radical surgery referred from urology to radiation oncology departments in Spain
verfasst von
A. Gómez Caamaño
A. Zapatero
J. López Torrecilla
X. Maldonado
Publikationsdatum
30.11.2015
Verlag
Springer International Publishing
Erschienen in
Clinical and Translational Oncology / Ausgabe 9/2016
Print ISSN: 1699-048X
Elektronische ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-015-1454-0

Weitere Artikel der Ausgabe 9/2016

Clinical and Translational Oncology 9/2016 Zur Ausgabe

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

25.04.2024 NSCLC Nachrichten

Das Risiko für Rezidiv oder Tod von Patienten und Patientinnen mit reseziertem ALK-positivem NSCLC ist unter einer adjuvanten Therapie mit dem Tyrosinkinase-Inhibitor Alectinib signifikant geringer als unter platinbasierter Chemotherapie.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.