Management of prostate cancer patients following radiation therapy after radical surgery referred from urology to radiation oncology departments in Spain
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To define usual clinical management of prostate cancer (PCa) patients following postoperative radiation therapy (RT) (adjuvant or salvage) and its evolution over time in radiation oncology (RO) departments in Spain.
An epidemiological, cross-sectional, multicentre study was conducted. 567 PCa patients that had undergone radical prostatectomy (RP) and received postoperative RT between February and December of both 2006 and 2011 participated in the study. In patients from 2006, health-related quality of life (HRQoL) was assessed using the EPIC questionnaire. Investigators completed a specific survey on two clinical cases of adjuvant and salvage RT.
70.6 % of patients received salvage RT versus 29.4 % who received adjuvant RT; no significant differences were found in terms of frequency for each procedure between both the years. Regarding the survey, a positive surgical margin was the main criteria used in adjuvant RT decision making. In terms of salvage RT scenario, 85.7 % of the investigators stated that adjuvant RT should have been offered instead, 81.4 % of the investigators agreed on a PSA score >0.2 ng/mL as the main criteria for identifying biochemical recurrence after RP, and 67.4 % of investigators did not consider any PSA score for ruling out salvage RT treatment.
Most patients are referred to RO departments to receive salvage RT. Despite the publication of three IA evidence level randomized clinical trials, the patterns for using adjuvant and salvage RT did not change from 2006 to 2011, although patients’ profile did. A consensus regarding postoperative RT indications should be reached in order to correct this controversial situation.
KeywordsProstate cancer Prostatectomy Radiation therapy Adjuvant Salvage
The authors would like to thank the following investigators for participating in the study: Algás Algás, Amparo Rosa; Álvarez González, Ana Mª; Andreu Martínez, Francisco José; Anglada Tort, Luís; Béjar Luque, Amelia; Biete Solá, Alberto; Boladeras Inglada, Ana Mª; Cabeza Rodríguez, Mª Ángeles; Cabrera Roldán, Patricia; Cantalapiedra del Pie, Mª del Rocío; Carballo Castro, Ana; Castillo Pérez, Isabel; Conde Moreno, Antonio José; Couñago Lorenzo, Felipe; del Cerro Peñalver, Elia; Escó Barón, Ricardo; Escribano Uzcudun, Ana; Ferrer Albiach, Carlos; Ferrer Albiach, Eduardo; Ferrer González, Ferrán; Foro Arnalot, Palmira; García Alonso, Elena; García Fernández, Ramón; Gómez Gómez, David; Gómez Heras, Laura; Gómez-Iturriaga, Alfonso; González Acosta, Pedro María; González San Segundo, Carmen; González Suárez, Herminio; Guerrero Grande, Araceli; Hervás Morón, Asunción; Ibáñez Villoslada, Carmen; Jiménez Salas, Rocío; Jové Teixido, Josep; López Campos, Fernando; López Soler, Francisco Javier; Lorente Sánchez, María; Lozano Galán, Joan; Ludeña Martínez, Blanca; Macías Hernández, Víctor; Mariño Cotelo, Alfonso; Mañas Rueda, Ana; Márquez García-Salazar, Mª Magdalena; Martín de Vidales, Carmen; Martínez Agra, Marta; Matute Martín, Raúl; Mira Flores, Moisés; Mira López, Jorge; Muñoz García, Julia Luísa; Nagore Cia, Gorka; Olivera Vegas, Jesús; Ossola Lentati, Gustavo; Otero, Ana; Palacios Eito, Amalia; Pastor Peidró, Jorge; Peleteiro Higuero, Paula; Pérez Casas, Ana Mª; Pinar Sedeño, Mª Beatriz; Prada Gómez, Pedro José; Puebla Díaz, Fernando; Ríos Asús, Patricia Viviana; Romero Rojano, Pilar; Rodríguez Liñán, Milagrosa; Rodríguez Villalba, Silvia; Rodríguez Zapatero, Ignacio; Samper Ots, Mª Pilar; Sánchez Saugar, Emilio; Sancho Pardo, Gemma; Soria Carreras, Pedro; Tormo Ferrero, Vicente; Tormo Micó, Alejandro; Trilla Martín, Jorge; Tripero Oter, Juana; Velilla Millán, Carmen; Villafranca Iturre, Elena; Viñals Montes, Pedro; Willisch Santamaría, Patricia; Zapata Paz, Irma.
Compliance with ethical standards
Disclosure of potential conflicts of interest
This study was funded by Astellas Pharma, SA, who also funded the logistics and technical support of IMS Health®. Authors claim having received honoraria from Astellas Pharma for conducting the study.
Research involving human participants and/or animals
The present study involved human participants, and it was conducted considering ethic responsibilities according to the World Medical Association and the Declaration of Helsinki.
All participants were informed of the study methodology and gave written informed consent prior to their inclusion in the study.
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