Barbara A Jereczek-Fossa1, Giulia Marvaso1, Mattia Zaffaroni2, Simone Giovanni Gugliandolo3, Dario Zerini4, Federica Corso5, Sara Gandini6, Filippo Alongi7, Alberto Bossi8, Philip Cornford9, Berardino De Bari10, Valérie Fonteyne11, Peter Hoskin12, Bradley R Pieters13, Alison C Tree14, Stefano Arcangeli15, Donald B Fuller16, Ciro Franzese17, Jean-Michel Hannoun-Levi18, Guillaume Janoray19, Linda Kerkmeijer20, Young Kwok21, Lorenzo Livi22, Mauro Loi23, Raymond Miralbell24, David Pasquier25, Michael Pinkawa26, Nathaliel Scher27, Marta Scorsetti17, Mohamed Shelan28, Alain Toledano27, Nicholas van As29, Andrea Vavassori4, Thomas Zilli30, Matteo Pepa4, Piet Ost11. 1. Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy. 2. Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy. Electronic address: mattia.zaffaroni@ieo.it. 3. Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Mechanical Engineering, Politecnico di Milano, Milan, Italy; Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy. 4. Division of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy. 5. Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy; Centre for Analysis Decisions and Society (CADS), Human Technopole, Department of Mathematics (DMAT) - MOX Laboratory, Politecnico di Milano, Milan, Italy. 6. Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy. 7. Department of Advanced Radiation Oncology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy; University of Brescia, Brescia, Italy. 8. Department of Radiation Oncology, Gustave Roussy Institute, Villejuif, France. 9. Liverpool University Hospitals Foundation NHS Trust, Liverpool, UK. 10. Radiation Oncology, Réseau Hospitalier Neuchâtelois, La Chaux-de-Fonds, Switzerland; University of Lausanne (UniL), Lausanne, Switzerland. 11. Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium. 12. Mount Vernon Cancer Centre, Northwood, UK; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK. 13. Department of Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands. 14. The Royal Marsden NHS Foundation Trust, London, UK; The Institute of Cancer Research, London, UK. 15. Department of Radiation Oncology, S. Gerardo Hospital, University of Milan Bicocca, Milan, Italy. 16. Department of Radiation Oncology, Genesis Health Care Partners, Inc, San Diego, CA, USA. 17. Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele - Milan, Italy. 18. Department of Radiation Oncology, Antoine Lacassagne Cancer Center, University of Côte d'Azur, Nice, France. 19. Department of Radiation-Oncology, Institut Jules Bordet-Université Libre de Bruxelles, Brussels, Belgium; University François-Rabelais, Tours, France. 20. Radboud University Medical Center, Nijmegen, Netherlands. 21. Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA. 22. Radiotherapy Department, University of Florence, Florence, Italy. 23. Radiotherapy Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy. 24. Institut Oncològic Teknon, Quironsalud, Barcelona, Spain. 25. Academic Department of Radiation Oncology, Centre O. Lambret, Lille, France; CRIStAL UMR 9189, Lille University, Lille, France. 26. Department of Radiation Oncology, MediClin Robert Janker Klinik, Bonn, Germany. 27. Hartmann Radiotherapy Institute, Hartmann Oncology Radiotherapy Group, Levallois-Perret, France; Rafael Institute Center for Predictive Medicine, Levallois-Perret, France. 28. Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 29. Department of Clinical Oncology, St Thomas' Hospital, London, UK. 30. Department of Radiation Oncology, Geneva University Hospital, Geneva, Switzerland; Faculty of Medicine, Geneva University, Geneva, Switzerland.
Abstract
BACKGROUND AND PURPOSE: Between 30% and 47% of patients treated with definitive radiotherapy (RT) for prostate cancer are at risk of intraprostatic recurrence during follow-up. Re-irradiation with stereotactic body RT (SBRT) is emerging as a feasible and safe therapeutic option. However, no consensus or guidelines exist on this topic. The purpose of this ESTRO ACROP project is to investigate expert opinion on salvage SBRT for intraprostatic relapse after RT. MATERIALS AND METHODS: A 40-item questionnaire on salvage SBRT was prepared by an internal committee and reviewed by a panel of leading radiation oncologists plus a urologist expert in prostate cancer. Following the procedure of a Delphi consensus, 3 rounds of questionnaires were sent to selected experts on prostate re-irradiation. RESULTS: Among the 33 contacted experts, 18 (54.5%) agreed to participate. At the end of the final round, participants were able to find consensus on 14 out of 40 questions (35% overall) and major agreement on 13 questions (32.5% overall). Specifically, the consensus was reached regarding some selection criteria (no age limit, ECOG 0-1, satisfactory urinary flow), diagnostic procedures (exclusion of metastatic disease, SBRT target defined on the MRI) and therapeutic approach (no need for concomitant ADT, consideration of the first RT dose, validity of Phoenix criteria for salvage SBRT failure). CONCLUSION: While awaiting the results of ongoing studies, our ESTRO ACROP Delphi consensus may serve as a practical guidance for salvage SBRT. Future research should address the existing disagreements on this promising approach.
BACKGROUND AND PURPOSE: Between 30% and 47% of patients treated with definitive radiotherapy (RT) for prostate cancer are at risk of intraprostatic recurrence during follow-up. Re-irradiation with stereotactic body RT (SBRT) is emerging as a feasible and safe therapeutic option. However, no consensus or guidelines exist on this topic. The purpose of this ESTRO ACROP project is to investigate expert opinion on salvage SBRT for intraprostatic relapse after RT. MATERIALS AND METHODS: A 40-item questionnaire on salvage SBRT was prepared by an internal committee and reviewed by a panel of leading radiation oncologists plus a urologist expert in prostate cancer. Following the procedure of a Delphi consensus, 3 rounds of questionnaires were sent to selected experts on prostate re-irradiation. RESULTS: Among the 33 contacted experts, 18 (54.5%) agreed to participate. At the end of the final round, participants were able to find consensus on 14 out of 40 questions (35% overall) and major agreement on 13 questions (32.5% overall). Specifically, the consensus was reached regarding some selection criteria (no age limit, ECOG 0-1, satisfactory urinary flow), diagnostic procedures (exclusion of metastatic disease, SBRT target defined on the MRI) and therapeutic approach (no need for concomitant ADT, consideration of the first RT dose, validity of Phoenix criteria for salvage SBRT failure). CONCLUSION: While awaiting the results of ongoing studies, our ESTRO ACROP Delphi consensus may serve as a practical guidance for salvage SBRT. Future research should address the existing disagreements on this promising approach.
Authors: Morgan Michalet; Olivier Riou; Jeremy Cottet-Moine; Florence Castan; Sophie Gourgou; Simon Valdenaire; Pierre Debuire; Norbert Ailleres; Roxana Draghici; Marie Charissoux; Carmen Llacer Moscardo; Marie-Pierre Farcy-Jacquet; Pascal Fenoglietto; David Azria Journal: Cancers (Basel) Date: 2022-04-12 Impact factor: 6.575
Authors: Jim Zhong; Finbar Slevin; Andrew F Scarsbrook; Maria Serra; Ananya Choudhury; Peter J Hoskin; Sarah Brown; Ann M Henry Journal: Front Oncol Date: 2021-09-09 Impact factor: 6.244