TY - JOUR
T1 - Patterns of practice regarding use of radiation therapy following radical prostatectomy : a survey of radiation oncologists and urologists in Australia and New Zealand
AU - Lawless, A.
AU - Kneebone, A.
AU - Armstrong, S.
AU - Chander, S.
AU - Christie, D.
AU - Finnigan, R.
AU - Hayden, Amy
AU - Higgs, B.
AU - Knox, M.
AU - Sasso, G.
AU - Sidhom, M.
AU - Shakespeare, T. P.
AU - Holt, T.
PY - 2023/8
Y1 - 2023/8
N2 - Introduction: This study aimed to investigate the patterns of practices of radiation oncologists (ROs) and urologists in Australia and New Zealand with respect to the utilisation of post-prostatectomy radiation therapy (RT) and help guide the development of an update to the existing Faculty of Radiation Oncology Genito-Urinary Group post-prostatectomy guidelines. Methods: ROs and urologists with subspecialty practice in prostate cancer from Australia and New Zealand were invited to participate in an online survey comprised of clinical scenarios regarding post-prostatectomy RT. Results: Sixty-five ROs and 28 urologists responded to the survey. In the setting of low-risk biochemical relapse, the threshold for initiating RT was lower for ROs than urologists. ROs were more likely than urologists to recommend adjuvant RT for node-positive disease. When salvage RT was advised for a pT3N0R1 recurrence, there was no consensus amongst ROs on whether to add either ADT or nodal treatment over prostate bed RT alone. For a solitary PSMA-avid pelvic lymph node recurrence, whole pelvis RT with androgen deprivation therapy was the preferred treatment option (72% ROs, 43% urologists). Most ROs (92%) recommended conventionally fractionated RT to 66–70 Gy, with a boost to any PSMA PET avid recurrent disease. Conclusion: This survey highlights the marked discordance in practice for the management of prostate cancer relapse post-prostatectomy. This is seen not only between specialties but also within the radiation oncology community. This emphasises the need for an updated evidence-based guideline to be produced.
AB - Introduction: This study aimed to investigate the patterns of practices of radiation oncologists (ROs) and urologists in Australia and New Zealand with respect to the utilisation of post-prostatectomy radiation therapy (RT) and help guide the development of an update to the existing Faculty of Radiation Oncology Genito-Urinary Group post-prostatectomy guidelines. Methods: ROs and urologists with subspecialty practice in prostate cancer from Australia and New Zealand were invited to participate in an online survey comprised of clinical scenarios regarding post-prostatectomy RT. Results: Sixty-five ROs and 28 urologists responded to the survey. In the setting of low-risk biochemical relapse, the threshold for initiating RT was lower for ROs than urologists. ROs were more likely than urologists to recommend adjuvant RT for node-positive disease. When salvage RT was advised for a pT3N0R1 recurrence, there was no consensus amongst ROs on whether to add either ADT or nodal treatment over prostate bed RT alone. For a solitary PSMA-avid pelvic lymph node recurrence, whole pelvis RT with androgen deprivation therapy was the preferred treatment option (72% ROs, 43% urologists). Most ROs (92%) recommended conventionally fractionated RT to 66–70 Gy, with a boost to any PSMA PET avid recurrent disease. Conclusion: This survey highlights the marked discordance in practice for the management of prostate cancer relapse post-prostatectomy. This is seen not only between specialties but also within the radiation oncology community. This emphasises the need for an updated evidence-based guideline to be produced.
UR - https://hdl.handle.net/1959.7/uws:78099
U2 - 10.1111/1754-9485.13552
DO - 10.1111/1754-9485.13552
M3 - Article
SN - 1754-9485
SN - 1754-9477
VL - 67
SP - 556
EP - 563
JO - Journal of Medical Imaging and Radiation Oncology
JF - Journal of Medical Imaging and Radiation Oncology
IS - 5
ER -