We received 583 answers (91.2% RO and 8.9% CO) from 100 countries. Most work in Academic Centers
(56.8%), have more than 10 years experience in treating prostate cancer (59.9%)
and 47.3% have more than 10 prostate cancer patients under active
treatment/month.
In case of a local recurrence after RT, 493 (84.6%) reported using
salvage treatments. The main reasons for not proposing salvage therapies were: life
expectancy < 5 years (53.7%), rectal late toxicity ≥ G3 from previous RT
(47.5%) and concomitant lymph nodal relapse (25%). For confirming local relapses,
mpMRI was considered necessary by 60.1% of respondents, a biopsy with histology
by 58.7%, and a PSMA-PET by 47% of them.
For those not recommending any salvage treatment, the main concern regarding re-RT was
its safety (77.8%) or efficacy (35.6%).
If salvage therapy was considered
necessary and safe, both RO’s and CO’s mentioned applying most often HDR-BT
(49.3%), SBRT (45.8%), prostatectomy (41%), IMRT (29%), and LDR-BT (22.1%).
From the 493 respondents who declared recommending salvage treatments, 334 (67.7%) personally
treated patients with re-RT. Of those, 41.9% used EBRT only, 29.3% used BT
only, and 28.7% used both EBRT and BT. When EBRT was delivered, 85.59% utilized
SBRT, 58% IMRT and 7.2% proton therapy. From those usingBT,75.8% declared using
HDR-BT and 32.5% LDR-BT, respectively. Concurrent use of ADT with re-RT in the
setting of salvage therapy was reported by 60.2% of RO’s and CO’s. A minimum interval of 24
months between the first RT and re-RT was considered acceptable by 35.6%, while
a similar proportion (32%) accepted an interval of only 12 months.
A
rise of 2 ng above nadir was used by 56.9% of RO’s and CO’s for defining biochemical
relapse after ST, and 3 consecutive rises after nadir, by 28.7% of them.