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27.06.2017 | Original Article

Salvage radiotherapy for macroscopic local recurrences after radical prostatectomy

A national survey on patterns of practice

verfasst von: Dr. Alan Dal Pra, Cedric Panje, Thomas Zilli, Winfried Arnold, Kathrin Brouwer, Helena Garcia, Markus Glatzer, Silvia Gomez, Fernanda Herrera, Khanfir Kaouthar, Alexandros Papachristofilou, Gianfranco Pesce, Christiane Reuter, Hansjörg Vees, Daniel Rudolf Zwahlen, Daniel Engeler, Paul Martin Putora

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 1/2018

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Abstract

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.

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Titel: Salvage radiotherapy for macroscopic local recurrences after radical prostatectomy
A national survey on patterns of practice
verfasst von: Dr. Alan Dal Pra
Cedric Panje
Thomas Zilli
Winfried Arnold
Kathrin Brouwer
Helena Garcia
Markus Glatzer
Silvia Gomez
Fernanda Herrera
Khanfir Kaouthar
Alexandros Papachristofilou
Gianfranco Pesce
Christiane Reuter
Hansjörg Vees
Daniel Rudolf Zwahlen
Daniel Engeler
Paul Martin Putora
Publikationsdatum: 27.06.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 1/2018
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-017-1172-3

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Springer Medizin

Salvage radiotherapy for macroscopic local recurrences after radical prostatectomy

A national survey on patterns of practice

Abstract

Introduction

Material and methods

Results

Conclusion

Neu im Fachgebiet Onkologie

Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Krebspatienten impfen: Was? Wen? Und wann nicht?

Müde im Alter? Auch an die Nebenniere denken

Update Onkologie

Springer Medizin

Abstract

Introduction

Material and methods

Results

Conclusion

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Thank you to all reviewers of Strahlentherapie und Onkologie 2017

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