Patterns of practice regarding use of radiation therapy following radical prostatectomy: A survey of Radiation Oncologists and Urologists in Australia and New Zealand

Lawless, A; Kneebone, A; Armstrong, S; Chander, S; Christie, D; Finnigan, R; Hayden, A; Higgs, B; Knox, M; Sasso, G; Sidhom, M; Shakespeare, TP; Holt, T

Author(s): Lawless, A; Kneebone, A; Armstrong, S; Chander, S; Christie, D; Finnigan, R; Hayden, A; Higgs, B; Knox, M; Sasso, G; Sidhom, M; Shakespeare, TP; Holt, T;
Details: Publication Year 2023-08,Volume 67,Issue #5,Page 556-563
Journal Title: Journal of Medical Imaging and Radiation Oncology
Publication Type: Research article
Abstract: 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.
Publisher: Wiley
Keywords: Male; Humans; *Urologists; Prostate/pathology; *Prostatic Neoplasms/radiotherapy/surgery/pathology; Radiation Oncologists; New Zealand; Androgen Antagonists; Reactive Oxygen Species; Neoplasm Recurrence, Local/surgery; Prostatectomy; Salvage Therapy; Australia; Radiation Oncology
Department(s): Radiation Oncology
PubMed ID: 37343171
Publisher's Version: https://doi.org/10.1111/1754-9485.13552
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-11-02 06:14:32

Last Modified: 2024-07-09 05:47:00