Practice patterns for prostate cancer in nine central and northern Italy radiation oncology centers: a survey including 1759 patients treated during two decades (1980–1998)

Magrini, Stefano Maria; Bertoni, F.; Vavassori, V.; Villa, Sergio; Cagna, E.; Maranzano, Ernesto; Pertici, Maurizio; Pradella, R.; Spediacci, M.A.; Chiavacci, A.; Ambrosi, E.; Livi, Lorenzo; Magli, A.; Bellavita, Rita; Bossi, Alberto; Biti, Gianpaolo

doi:10.1016/s0360-3016(01)02783-3

Cited by 15 publications

(11 citation statements)

References 26 publications

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“…Comparison of the late sequelae reported for surgery alone with those observed after postoperative RTT (in our series and others) identified no major differences [15]. Likewise, in terms of late sequelae, radiotherapy alone for prostate cancer has similar toxicity to postoperative RTT, as shown by the results of a recent Italian multicentre study [16].…”

Section: Discussionsupporting

confidence: 78%

“…Confrontando le sequele tardive della sola chirurgia, documentate in letteratura, con quelle osservate dopo RTT post-operatoria (in questa come in altre casistiche), non si sono osservate differenze sostanziali [15]. Allo stesso modo, in termini di sequele tardive, il trattamento radioterapico esclusivo del cancro prostatico è gravato da una tossicità simile a quella della RTT post-operatoria, come si può ad esempio osservare considerando i risultati di un recente studio multicentrico italiano [16]. L'associazione con la ormonoterapia è stata praticata, con farmaci e per durate diverse, nella grande maggioranza dei casi trattati sia con radioterapia adiuvante che di salvataggio: ciò preclude una valutazione attendibile del ruolo terapeutico del blocco androgenico in questa casistica.…”

Section: Discussionunclassified

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Postoperative radiotherapy after radical prostatectomy for prostate carcinoma: the experience of the Brescia Radium Institute

et al. 2006

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Section: Discussionsupporting

confidence: 78%

Section: Discussionunclassified

Postoperative radiotherapy after radical prostatectomy for prostate carcinoma: the experience of the Brescia Radium Institute

et al. 2006

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“…In Italy, an increase in the use of External Beam RT (EBRT) for curative treatment of PCA has been documented in two subsequent patterns of practice studies run under the aegis of Italian Association for Radiotherapy and Clinical Oncology (AIRO) [32–33]. In the present study, patients treated with EBRT have been referred to radiation oncologist for the most by urologists.…”

Section: Discussionmentioning

confidence: 88%

Treatment paths for localised prostate cancer in Italy: The results of a multidisciplinary, observational, prospective study (Pros-IT CNR)

et al. 2019

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BackgroundThere are several treatments available to newly diagnosed prostate cancer (PCA) patients. Although surgery and radiotherapy (RT) with or without androgen deprivation therapy (ADT) are widely adopted treatment options for localized PCA together with active surveillance (AS), there is no consensus nor randomised trials on treatment selection, prospective quality of life (QOL), along with toxicity outcomes and according to treatment modality in the Italian population. The current study aimed to describe clinical-therapeutic features and QOL at PCA diagnosis, according to different treatment patterns in a large prospective, Italian population, enrolled in the Pros-IT CNR study.MethodsThe Pros-IT CNR is an on-going national, multicenter, observational, prospective study on patients affected by PCA who have been referred by 97 Italian Urology, Radiation Oncology and Medical Oncology facilities participating in the project. The possible relationships between the treatment patterns reported in the 6 month follow-up case report form and patients’ features at diagnosis were evaluated using exploratory multiple correspondence analysis (MCA) and other data analysis method.ResultsAt diagnosis, surgery and AS patients were significantly younger, had fewer comorbidities, lower PSA levels and Gleason Score (GS) values; they were also diagnosed at an earlier stage of disease with respect to the RT or ADT patients who showed significantly worse QoL scores at the time of diagnosis.ConclusionsAn analysis of the data collected at baseline and 6 months later uncovered substantial differences in ages, comorbidities, clinical and QOL features in the various treatment groups. These findings do not fully reflect the current PCA treatment guidelines and suggest the need for a multidisciplinary consensus guideline to ameliorate both the counselling and treatments of PCA patients.

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“…Modern EBRT techniques, that is, intensity modulated radiation therapy and image-guided radiation therapy have improved both biochemical control and the late toxicity profile. 1 – 3 Despite this, a variable rate of biochemical failure (22%-69%) is reported in literature. 2 , 4 , 5 Local recurrences were usually treated with salvage ADT.…”

Section: Introductionmentioning

confidence: 99%

“… 1 – 3 Despite this, a variable rate of biochemical failure (22%-69%) is reported in literature. 2 , 4 , 5 Local recurrences were usually treated with salvage ADT. To date, local treatment modalities such as brachytherapy, surgery, cryotherapy, and high-intensity–focused ultrasound (HIFU) have been increasingly proposed to patients harboring a gland-confined disease recurrence, to prevent hormonal therapy severe side effects.…”

Section: Introductionmentioning

confidence: 99%

Salvage Low Dose Rate Brachytherapy For Recurrent Prostate Cancer After External Beam Radiotherapy: Results From A Single Institution With Focus On Toxicity And Functional Outcomes

Barbera

Triggiani

Buglione

et al. 2017

Clin Med Insights Oncol

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Background/aim:Low dose rate brachytherapy has been used as salvage therapy for locally recurrent prostate cancer (PC) after primary external beam radiation therapy (EBRT), along with surgery and cryotherapy. All these techniques, in particular, when applied to the whole gland, involve a relatively high risk of toxicity and may worsen the patient’s quality of life. Our aim is to evaluate the results of whole-gland salvage brachytherapy (SBT) after primary EBRT in terms of toxicity, functional outcomes, and efficacy.Materials and methods:We retrospectively reviewed clinical data on 19 patients consecutively treated with SBT at our institution between June 2012 and November 2015. Local recurrences were identified with 11C-choline positron emission tomography/computed tomography and pelvic magnetic resonance imaging after biochemical recurrence according to Phoenix criteria (prostate-specific antigen nadir + 2). Low dose rate brachytherapy was performed by 125I permanent seeds implantation to the whole prostate gland, with a prescription dose of 130 Gy. At the time of SBT, only 2 patients were receiving androgen deprivation therapy. Acute and late toxicities were recorded using the CTCAE 4.0 scoring system. Quality of life was assessed using IPSS (International Prostate Symptoms Score) and IIEF (International Index of Erectile Function) questionnaires at baseline and 6, 12, and 24 months after SBT, and the respective mean values were compared using Student t test. Biochemical relapse-free survival (BRFS) was also calculated.Results:Median follow-up after SBT was 24 months. Of 19 patients, 2 patients experienced a G3 cystitis (10.2%) and 1 patient experienced a G4 proctitis (5.3%), respectively. Mean pre-SBT IPSS scores and 6, 12, and 24 months after SBT were 5.84, 10.22, 15.72, and 8.10, respectively. Mean pre-SBT IIEF scores and 6, 12, and 24 months after SBT were 8.42, 3.55, 7.89, and 6.40, respectively. At the time of analysis, only 2 patients showed a biochemical relapse (3-year BRFS 85.2%). The Student t test demonstrated a worsening of functional outcome 6 months and 1 year after treatment but a subsequent improvement 2 years after SBT.Conclusions:Salvage brachytherapy for recurrent PC after primary EBRT seems to be a feasible treatment for selected patients. Our series revealed a severe toxicity peak 6 months and 1 year after local re-treatment and then they decrease. Early BRFS rates are good. However, these are very preliminary results so further patient accrual, long-term follow-up, and prospective trials are needed in the future.

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Practice patterns for prostate cancer in nine central and northern Italy radiation oncology centers: a survey including 1759 patients treated during two decades (1980–1998)

Cited by 15 publications

References 26 publications

Postoperative radiotherapy after radical prostatectomy for prostate carcinoma: the experience of the Brescia Radium Institute

Postoperative radiotherapy after radical prostatectomy for prostate carcinoma: the experience of the Brescia Radium Institute

Treatment paths for localised prostate cancer in Italy: The results of a multidisciplinary, observational, prospective study (Pros-IT CNR)

Salvage Low Dose Rate Brachytherapy For Recurrent Prostate Cancer After External Beam Radiotherapy: Results From A Single Institution With Focus On Toxicity And Functional Outcomes

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