Postoperative radiotherapy after upfront radical prostatectomy: debated issues at a turning point—a survey exploring management trends on behalf of AIRO (Italian Association of Radiotherapy and Clinical Oncology)

Abstract

Objectives Postoperative prostate cancer patients are a heterogeneous population, and many prognostic factors (e.g., local staging, PSA kinetics, margin status, histopathological features) may influence their clinical management. In this complex scenario, univocal recommendations are often lacking. For these reasons, the present survey was developed by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) to collect the opinion of Italian radiation oncologists and delineate a representation of current clinical practice in our country. Methods A questionnaire was administered online to AIRO (Italian Association of Radiotherapy and Clinical Oncology) members registered in 2020 with a clinical interest in uro-oncological disease. Results Sixty-one per cent of AIRO members answered the proposed survey. Explored topics included career and expertise, indications to adjuvant RT, additional imaging in biochemical recurrence setting, use of salvage radiotherapy (SRT), management of clinically evident locoregional recurrence and future considerations. Conclusions Overall, good level of agreement was found between participants for most of the topics. Most debated issues regarded, as expected, implementation of new imaging methods in this setting. Notably, trend in favour of early SRT vs. immediate adjuvant RT was underlined, and preference for global evaluation rather than isolated risk factors for RT indications was noticed.

Hypofractionated Postoperative Radiotherapy in Prostate Cancer with Ialuril Soft Gels®: Toxicity and Efficacy Analysis on a Retrospective Series of 305 Patients

“…Alternatively, PSA can be followed over time, and only when it begins to present values >0.2 ng/mL in two consecutive dosages, a salvage RT can be done. 16 Some studies have shown that salvage radiotherapy is not inferior to adjuvant radiotherapy in terms of oncological outcomes, and moreover it would seem to ensure lower toxicity. 6 Currently, urinary toxicity remains one of the main clinical issue in this scenario, being the bladder neck part of the treatment volume.…”