Patterns of Care Related to Post-Operative Radiotherapy for Patients with Prostate Cancer among Canadian Radiation Oncologists and Urologists
The American Society for Radiation Oncology (ASTRO) and American Urological Association (AUA) developed post-prostatectomy radiotherapy (RT) guidelines to aid patient counseling on adjuvant (ART) and salvage radiotherapy (SRT). Our study compared how aware and compliant Canadian radiation oncologists and urologists are to these guidelines. Our online survey was distributed through the Canadian Association of Radiation Oncology (CARO) and Canadian Urology Association (CUA) to radiation oncologists and urologists that treat prostate cancer. We used Wilcoxon rank-sum test and Chi-square test to compare radiation oncologists and urologists. P values for significant findings are reported. A total of 128 participants responded the survey, 52 radiation oncologists, and 76 urologists. The majority (82%) of radiation oncologists had read these guidelines, compared to only 49% of urologists (p < 0.001). Radiation oncologists were more likely to recommend ART >50% for adverse pathological findings post-radical prostatectomy compared to urologists (76 vs. 51%, p = 0.011). Urologists were more likely to monitor their patient’s PSA level post-prostatectomy compared to radiation oncologists (93 vs. 77%, p = 0.016). Post-thematic analysis of open-ended questions revealed that urologists rarely refer patients to radiation oncologists for ART, with radiation oncologists confirming that they rarely receive referrals. This study demonstrates the low compliance to ASTRO/AUA guidelines. While radiation oncologists were more aware and compliant to guidelines, urologists were significantly more likely to monitor their patient’s PSA. This study highlighted the need for better communication between urologists and radiation oncologists, especially in referrals for ART, to facilitate treatment delivery that is concordant with ASTRO/AUA guidelines.
KeywordsRadioterapy Prostate cancer Prostatectomy
- 1.Canadian Cancer Society’s Advisory Committee on Cancer Statistics (2014) Canadian cancer statistics. Canadian Cancer Society, TorontoGoogle Scholar
- 3.Thompson IM, Tangen CM, Paradelo J et al (2009) 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 181:956–962. doi: 10.1016/j.juro.2008.11.032 CrossRefPubMedPubMedCentralGoogle Scholar
- 5.RTOG 0534 Protocol Information. Last accessed January 17, 2017. http://www.rtog.org/clinicaltrials/protocoltable/studydetails.aspx?study=0534. Accessed August 18, 2015.
- 11.Zimmermann M, Taussky D, Delouya G, Alenizi AM, Zorn KC (2015) Radiation therapy after radical prostatectomy: a single-centre radiation oncology experience in trends of referral and treatment practices. Can Urol Assoc J 9(9–10):E608–E612. doi: 10.5489/cuaj.2815 CrossRefPubMedPubMedCentralGoogle Scholar