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Salvage prostate brachytherapy in radiorecurrent prostate cancer: An international Delphi consensus study.

Authors :
Corkum MT
Buyyounouski MK
Chang AJ
Chung HT
Chung P
Cox BW
Crook JM
Davis BJ
Frank SJ
Henriquez I
Horwitz EM
Hoskin P
Hsu IC
Keyes M
King MT
Kollmeier MA
Krauss DJ
Kukielka AM
Morton G
Orio PF 3rd
Pieters BR
Potters L
Rossi PJ
Showalter TN
Solanki AA
Song D
Vanneste B
Vigneault E
Wojcieszek PA
Zelefsky MJ
Kamrava M
Source :
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2023 Jul; Vol. 184, pp. 109672. Date of Electronic Publication: 2023 Apr 13.
Publication Year :
2023

Abstract

Background and Purpose: Local recurrences after previous radiotherapy (RT) are increasingly being identified in biochemically recurrent prostate cancer. Salvage prostate brachytherapy (BT) is an effective and well tolerated treatment option. We sought to generate international consensus statements on the use and preferred technical considerations for salvage prostate BT.<br />Materials and Methods: International experts in salvage prostate BT were invited (n = 34) to participate. A three-round modified Delphi technique was utilized, with questions focused on patient- and cancer-specific criteria, type and technique of BT, and follow-up. An a priori threshold for consensus of ≥ 75% was set, with a majority opinion being ≥ 50%.<br />Results: Thirty international experts agreed to participate. Consensus was achieved for 56% (18/32) of statements. Consensus was achieved in several areas of patient selection: 1) A minimum of 2-3 years from initial RT to salvage BT; 2) MRI and PSMA PET should be obtained; and 3) Both targeted and systematic biopsies should be performed. Several areas did not reach consensus: 1) Maximum T stage/PSA at time of salvage; 2) Utilization/duration of ADT; 3) Appropriateness of combining local salvage with SABR for oligometastatic disease and 4) Repeating a second course of salvage BT. A majority opinion preferred High Dose-Rate salvage BT, and indicated that both focal and whole gland techniques could be appropriate. There was no single preferred dose/fractionation.<br />Conclusion: Areas of consensus within our Delphi study may serve as practical advice for salvage prostate BT. Future research in salvage BT should address areas of controversy identified in our study.<br />Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (Copyright © 2023 Elsevier B.V. All rights reserved.)

Details

Language :
English
ISSN :
1879-0887
Volume :
184
Database :
MEDLINE
Journal :
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Publication Type :
Academic Journal
Accession number :
37059334
Full Text :
https://doi.org/10.1016/j.radonc.2023.109672