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

Autor: G. Pesce, Cédric M. Panje, Kathrin Brouwer, Silvia Gomez, K. Khanfir, Paul Martin Putora, Thomas Zilli, Daniel R. Zwahlen, Alexandros Papachristofilou, Alan Dal Pra, Helena Garcia Schüler, Winfried Arnold, Fernanda G. Herrera, Christiane Reuter, H. Vees
Přispěvatelé: University of Zurich, Panje, Cedric
Rok vydání: 2019
Předmět:
Male
medicine.medical_treatment
030232 urology & nephrology
Disease
Androgen deprivation therapy
Prostate cancer
0302 clinical medicine
Prospective Studies
Practice Patterns
Physicians'
610 Medicine & health
Lymph node
Pelvic Neoplasms
SBRT
Prostatectomy
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Prognosis
10044 Clinic for Radiation Oncology
Dissection
medicine.anatomical_structure
Oncology
Radiology Nuclear Medicine and imaging
030220 oncology & carcinogenesis
2730 Oncology
Radiology
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty
lcsh:R895-920
ddc:616.0757
lcsh:RC254-282
03 medical and health sciences
Oligometastatic
medicine
2741 Radiology
Nuclear Medicine and Imaging
Humans
Radiology
Nuclear Medicine and imaging
Decision criteria
Salvage Therapy
Performance status
Radiotherapy
business.industry
Patient Selection
Research
Prostatic Neoplasms
medicine.disease
Radiation therapy
Nodal recurrence
Neoplasm Recurrence
Local
business
Decision making
Zdroj: Radiation Oncology (London, England)
Radiation Oncology, Vol 14, Iss 1, Pp 1-7 (2019)
Radiation Oncology, Vol. 14, No 1 (2019) P. 177
Panje, Cedric; Zilli, Thomas; Dal Pra, Alan; Arnold, Winfried; Brouwer, Kathrin; Garcia Schüler, Helena I; Gomez, Silvia; Herrera, Fernanda; Khanfir, Kaouthar; Papachristofilou, Alexandros; Pesce, Gianfranco; Reuter, Christiane; Vees, Hansjörg; Zwahlen, Daniel; Putora, Paul Martin (2019). Radiotherapy for pelvic nodal recurrences after radical prostatectomy: patient selection in clinical practice. Radiation oncology, 14(1), p. 177. BioMed Central 10.1186/s13014-019-1383-0
ISSN: 1748-717X
Popis: Aim 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. Methods 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. Results 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. Conclusions 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.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje