Salvage prostate brachytherapy in radiorecurrent prostate cancer: An international Delphi consensus study Journal Article
| Authors: | Corkum, M. T.; Buyyounouski, M. K.; Chang, A. J.; Chung, H. T.; Chung, P.; Cox, B. W.; Crook, J. M.; Davis, B. J.; Frank, S. J.; Henriquez, I.; Horwitz, E. M.; Hoskin, P.; Hsu, I. C.; Keyes, M.; King, M. T.; Kollmeier, M. A.; Krauss, D. J.; Kukielka, A. M.; Morton, G.; Orio, P. F., III; Pieters, B. R.; Potters, L.; Rossi, P. J.; Showalter, T. N.; Solanki, A. A.; Song, D.; Vanneste, B.; Vigneault, E.; Wojcieszek, P. A.; Zelefsky, M. J.; Kamrava, M. |
| Article Title: | Salvage prostate brachytherapy in radiorecurrent prostate cancer: An international Delphi consensus study |
| 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. 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%. 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. 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. © 2023 Elsevier B.V. |
| Keywords: | adult; clinical article; controlled study; disease course; cancer recurrence; salvage therapy; patient selection; treatment duration; radiation dose; nuclear magnetic resonance imaging; outcome assessment; positron emission tomography; follow up; consensus; clinical assessment; prostate cancer; prostate specific membrane antigen; radiation dose fractionation; prostate biopsy; brachytherapy; delphi study; stereotactic body radiation therapy; medical expert; prostate brachytherapy; salvage brachytherapy; human; male; article; recurrent prostate cancer; delphi consensus |
| Journal Title: | Radiotherapy and Oncology |
| Volume: | 184 |
| ISSN: | 0167-8140 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2023-07-01 |
| Start Page: | 109672 |
| Language: | English |
| DOI: | 10.1016/j.radonc.2023.109672 |
| PUBMED: | 37059334 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 June 2023 -- Source: Scopus |
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