Treating oligometastatic prostate cancer – a survey among the German Society for Radiation Oncology
MO-0556
Abstract
Treating oligometastatic prostate cancer – a survey among the German Society for Radiation Oncology
Authors: Paul Rogowski1, Christian Trapp1, Rieke von Bestenbostel1, Dinah Konnerth1, Sebastian Marschner1, Nina-Sophie Schmidt Hegemann1, Claus Belka1,2, Minglun Li1
1University Hospital, LMU Munich, Department of Radiation Oncology, Munich, Germany; 2German Cancer Consortium (DKTK), German Cancer Consortium (DKTK), Munich, Germany
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Purpose or Objective
Due to improved imaging, oligometastatic prostate cancer (OMPC) is diagnosed more frequently. Growing evidenceshows that patients with a limited number of metastases benefit from primary-directed (PDT) as well as from metastasis-directed radiotherapy (MDT). The purpose of this survey was to investigate the current treatment practice for OMPC among German radiation oncologists.
Material and Methods
Members of the German Society for Radiation Oncology (DEGRO) were surveyed via an anonymous online questionnaire sent by e-mail. The survey included six general items and 14 specific items regarding treatment characteristics. Questionnaires with at least 50 percent of questions completed were considered for further analysis.
Results
A total of 204 responses were received (15% response rate). 167 were considered for further analysis. Most respondents stated to be specialized in treating prostate cancer patients and to treat 10-30 patients with OMPC per annum. 97% considered PSMA-PET/CT necessary to define oligometastatic disease. Opinions differed regarding the use of systemic therapies: 63% of the respondents aimed to defer systemic therapy using radiotherapy in OMPC, 37% considered systemic therapy as necessary. In the setting of synchronous OMPC, 97% recommended PDT with or without a combination of MDT and/or systemic therapy. For metachronous nodal or bone oligometastatic recurrence, 98% and 99%, respectively, would opt for MDT. The majority would combine MDT with systemic therapy in patients with metachronous oligorecurrence. Respondents recommended normofractionation, hypofractionation and SBRT for lymph node metastases in 49%, 27% and 24%, respectively. No consensus existed regarding the field size for MDT of lymph node metastases. Most respondents preferred > 5 fractions for treatment of bone metastases.
Conclusion
Local radiotherapy for PDT and MDT is routinely used among German radiation oncologists. The timing of systemic therapy, fractionation schedules and field sizes are handled differently and remain an area of active investigation.