TY - JOUR
T1 - Salvage stereotactic body radiotherapy (SBRT) for intraprostatic relapse after prostate cancer radiotherapy: An ESTRO ACROP Delphi consensus
AU - Jereczek-Fossa, Barbara A.
AU - Marvaso, Giulia
AU - Zaffaroni, Mattia
AU - Gugliandolo, Simone Giovanni
AU - Zerini, Dario
AU - Corso, Federica
AU - Gandini, Sara
AU - Alongi, Filippo
AU - Bossi, Alberto
AU - Cornford, Philip
AU - de Bari, Berardino
AU - Fonteyne, Valérie
AU - Hoskin, Peter
AU - Pieters, Bradley R.
AU - Tree, Alison C.
AU - Arcangeli, Stefano
AU - Fuller, Donald B.
AU - Franzese, Ciro
AU - Hannoun-Levi, Jean-Michel
AU - Janoray, Guillaume
AU - Kerkmeijer, Linda
AU - Kwok, Young
AU - Livi, Lorenzo
AU - Loi, Mauro
AU - Miralbell, Raymond
AU - Pasquier, David
AU - Pinkawa, Michael
AU - Scher, Nathaliel
AU - Scorsetti, Marta
AU - Shelan, Mohamed
AU - Toledano, Alain
AU - van As, Nicholas
AU - Vavassori, Andrea
AU - on the behalf of the European Society for Radiotherapy, Oncology Advisory Committee on Radiation Oncology Practice (ESTRO ACROP)
AU - Zilli, Thomas
AU - Pepa, Matteo
AU - Ost, Piet
N1 - Funding Information: We would like to thank the ESTRO ACROP Committee and in particular Prof. C. Belka for the excellent collaboration on this project. We thank Eralda Azizaj for her extraordinary help in managing the project and communication among the Authors, Reviewers and the ACROP Committee. We thank European Association of Urology for kind collaboration to make this project inter-disciplinary.The institution of authors BAJF, MP, GM, MZ, DZ, SG, FC, and AV (IEO, European Institute of Oncology IRCCS, Milan, Italy) receives research support from the Italian Ministry of Health (Ricerca Corrente and 5x1000 funds). MZ received a research grant from Accuray Inc. (Data collection and analysis of Tomotherapy® and CyberKnife® breast clinical studies, breast physics studies and prostate study) outside the current study. The sponsors did not play any role in study design, execution and data analysis. BAJF reports personal fees from Janssen, personal fees from Ferring, personal fees from Bayer, personal fees from Roche, personal fees from Astellas, personal fees from Elekta, personal fees from Carl Zeiss, personal fees from Ipsen, grants and personal fees from Accuray, personal fees from IBA, grants from AIRC, grants from FIEO-CCM & FUV, outside the submitted work. BP reports grants from Elekta, outside the submitted work. AT reports grants and personal fees from Elekta, grants from Accuray, grants from Varian, personal fees from Janssen, personal fees from Bayer, personal fees from Ferring, personal fees from Genesis Healthcare, outside the submitted work. DF reports personal fees from Accuray outside the submitted work. PO reports grants from Varian, other from Janssen, other from Bayer, other from Ferring, grants from Merck, outside the submitted work. All the other authors have nothing to disclose. Acknowledgement for AT and NVA: This project represents independent research partly supported by the National Institute for Health research (NIHR) Biomedical Research Centre at The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Publisher Copyright: © 2021 Elsevier Ltd
PY - 2021/7/1
Y1 - 2021/7/1
N2 - 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.
AB - 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.
KW - Delphi consensus
KW - Recurrent prostate cancer
KW - Salvage radiotherapy
KW - Stereotactic body radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=85105286618&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.ctrv.2021.102206
DO - https://doi.org/10.1016/j.ctrv.2021.102206
M3 - Review article
C2 - 33965893
SN - 0305-7372
VL - 98
JO - Cancer Treatment Reviews
JF - Cancer Treatment Reviews
M1 - 102206
ER -