Display options
Cite
Shelan M, Aebersold DM, Albrecht C, et al. Moderately hypofractionated radiotherapy as definitive treatment for localized prostate cancer: Pattern of practice in German-speaking countries : A survey of the Prostate Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO) and the Working Party on Radiation Oncology of the German Cancer Society (DKG-ARO). Strahlenther Onkol. 2021;197(11):993-1000doi: 10.1007/s00066-021-01820-2.
Shelan, M., Aebersold, D. M., Albrecht, C., Böhmer, D., Flentje, M., Ganswindt, U., Höcht, S., Hölscher, T., Müller, A. C., Niehoff, P., Pinkawa, M., Schmidt-Hegemann, N. S., Sedlmayer, F., Wolf, F., Zamboglou, C., Zips, D., Wiegel, T., & Ghadjar, P. (2021). Moderately hypofractionated radiotherapy as definitive treatment for localized prostate cancer: Pattern of practice in German-speaking countries : A survey of the Prostate Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO) and the Working Party on Radiation Oncology of the German Cancer Society (DKG-ARO). Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 197(11), 993-1000. https://doi.org/10.1007/s00066-021-01820-2
Shelan, Mohamed, et al. "Moderately hypofractionated radiotherapy as definitive treatment for localized prostate cancer: Pattern of practice in German-speaking countries : A survey of the Prostate Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO) and the Working Party on Radiation Oncology of the German Cancer Society (DKG-ARO)." Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] vol. 197,11 (2021): 993-1000. doi: https://doi.org/10.1007/s00066-021-01820-2
Shelan M, Aebersold DM, Albrecht C, Böhmer D, Flentje M, Ganswindt U, Höcht S, Hölscher T, Müller AC, Niehoff P, Pinkawa M, Schmidt-Hegemann NS, Sedlmayer F, Wolf F, Zamboglou C, Zips D, Wiegel T, Ghadjar P. Moderately hypofractionated radiotherapy as definitive treatment for localized prostate cancer: Pattern of practice in German-speaking countries : A survey of the Prostate Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO) and the Working Party on Radiation Oncology of the German Cancer Society (DKG-ARO). Strahlenther Onkol. 2021 Nov;197(11):993-1000. doi: 10.1007/s00066-021-01820-2. Epub 2021 Aug 31. PMID: 34463814; PMCID: PMC8545730.
Copy Download .nbib Format: NLM
Share it on

Strahlenther Onkol. 2021 Nov;197(11):993-1000. doi: 10.1007/s00066-021-01820-2. Epub 2021 Aug 31.

Moderately hypofractionated radiotherapy as definitive treatment for localized prostate cancer: Pattern of practice in German-speaking countries : A survey of the Prostate Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO) and the Working Party on Radiation Oncology of the German Cancer Society (DKG-ARO).

Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]

Mohamed Shelan, Daniel M Aebersold, Clemens Albrecht, Dirk Böhmer, Michael Flentje, Ute Ganswindt, Stefan Höcht, Tobias Hölscher, Arndt-Christian Müller, Peter Niehoff, Michael Pinkawa, Nina-Sophie Schmidt-Hegemann, Felix Sedlmayer, Frank Wolf, Constantinos Zamboglou, Daniel Zips, Thomas Wiegel, Pirus Ghadjar

Affiliations

  1. Universitätsklinik für Radio-Onkologie, Inselspital, Universität Bern, Bern, Switzerland.
  2. Klinik für Radioonkologie und Gemeinschaftspraxis für Strahlentherapie, Klinikum Nürnberg Nord, Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Nuremberg, Germany.
  3. Klinik für Radioonkologie und Strahlentherapie, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany.
  4. Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Würzburg, Würzburg, Germany.
  5. Universitätsklinik für Strahlentherapie-Radioonkologie, Innsbruck, Austria.
  6. Xcare Praxis für Strahlentherapie Saarlouis, Xcare Gruppe, Saarlouis, Germany.
  7. Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
  8. Universitätsklinik für Radioonkologie, Universitätsklinikum Tübingen, Tübingen, Germany.
  9. Sana Klinikum Offenbach, Offenbach, Germany.
  10. MediClin Robert Janker Klinik, Bonn, Germany.
  11. Klinik und Poliklinik für Strahlentherapie und Radioonkologie, LMU Klinikum, Munich, Germany.
  12. Universitätsklinik für Radiotherapie und Radio-Onkologie, LKH, Universitätsklinikum der Paracelsus Medizinischen Privatuniversität, Müllner Hauptstraße 48, 5020, Salzburg, Austria.
  13. Klinik für Radio-Onkologie, Universitätsklinikum Freiburg, Freiburg, Germany.
  14. Klinik für Radioonkologie und Strahlentherapie, Universitätsklinikum Ulm, Ulm, Germany.
  15. Universitätsklinik für Radio-Onkologie, Inselspital, Universität Bern, Bern, Switzerland. [email protected].
  16. Klinik für Radioonkologie und Strahlentherapie, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany. [email protected].

PMID: 34463814 PMCID: PMC8545730 DOI: 10.1007/s00066-021-01820-2

Abstract

PURPOSE: Various randomized phase III clinical trials have compared moderately hypofractionated to normofractionated radiotherapy (RT). These modalities showed similar effectiveness without major differences in toxicity. This project was conducted by the Prostate Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO) and the Working Party on Radiation Oncology of the German Cancer Society. We aimed to investigate expert opinions on the use of moderately hypofractionated RT as a definitive treatment for localized prostate cancer in German-speaking countries.

METHODS: A 25-item, web-based questionnaire on moderate-hypofractionation RT was prepared by an internal committee. The experts of the DEGRO were asked to complete the questionnaire.

RESULTS: Fourteen active members of DEGRO completed the questionnaire. The questions described indications for selecting patients eligible to receive moderate hypofractionation based on clinical and pathological factors such as age, urinary symptoms, and risk-group. The questions also collected information on the technical aspects of selection criteria, including the definition of a clinical target volume, the use of imaging, protocols for bladder and rectal filling, the choice of a fractionation schedule, and the use of image guidance. Moreover, the questionnaire collected information on post-treatment surveillance after applying moderately hypofractionated RT.

CONCLUSION: Although opinions varied on the use of moderate-hypofractionation RT, the current survey reflected broad agreement on the notion that moderately hypofractionated RT could be considered a standard treatment for localized prostate cancer in German-speaking countries.

© 2021. The Author(s).

Keywords: Guidelines; Hypofractionation; Prostate cancer; Radiotherapy; Survey

References

  1. Wolf F, Sedlmayer F, Aebersold D et al (2021) Ultrahypofractionation of localized prostate cancer: statement from the DEGRO working group prostate cancer. Strahlenther Onkol 197(2):89–96 - PubMed
  2. Widmark A, Gunnlaugsson A, Beckman L et al (2019) Articles ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer: 5‑year outcomes of the HYPO-RT-PC randomised, non-inferiority, phase 3 trial. Lancet 394(10196):385–395 - PubMed
  3. Hickey BE, James ML, Daly T, Soh FY, Jeffery M (2019) Hypofractionation for clinically localized prostate cancer. Cochrane Database Syst Rev 9:CD11462 - PubMed
  4. Höcht S, Aebersold DM, Albrecht C et al (2017) Hypofractionated radiotherapy for localized prostate cancer. Strahlenther Onkol 193:1–12 - PubMed
  5. Ghadjar P, Aebersold DM, Albrecht C et al (2018) Use of androgen deprivation and salvage radiation therapy for patients with prostate cancer and biochemical recurrence after prostatectomy. Strahlenther Onkol 194:619–626 - PubMed
  6. Beck M, Böhmer D, Aebersold DM et al (2020) Role of combined radiation and androgen deprivation therapy in intermediate-risk prostate cancer: statement from the DEGRO working group on prostate cancer. Strahlenther Onkol 196:109–116 - PubMed
  7. Ghadjar P, Aebersold DM, Albrecht C et al (2020) Treatment strategies to prevent and reduce gynecomastia and/or breast pain caused by antiandrogen therapy for prostate cancer: statement from the DEGRO working group prostate cancer. Strahlenther Onkol 196:589–597 - PubMed
  8. Mottet N, van den Bergh RCN, Briers E et al (2021) EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer. Part II—2020 update: treatment of relapsing and metastatic prostate cancer. Eur Urol 79(2):263–282 - PubMed
  9. Catton CN, Lukka H, Gu CS et al (2017) Randomized trial of a hypofractionated radiation regimen for the treatment of localized prostate cancer. J Clin Oncol 35:1884–1890 - PubMed
  10. Dearnaley D, Syndikus I, Mossop H et al (2016) Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5‑year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial. Lancet Oncol 17:1047–1060 - PubMed
  11. Lee WR, Dignam JJ, Amin MB et al (2016) Randomized phase III noninferiority study comparing two radiotherapy fractionation schedules in patients with low-risk prostate cancer. J Clin Oncol 34:2325–2332 - PubMed
  12. Wilson JM, Dearnaley DP, Syndikus I et al (2018) The efficacy and safety of conventional and hypofractionated high-dose radiation therapy for prostate cancer in an elderly population: a subgroup analysis of the CHHiP trial. Int J Radiat Oncol Biol Phys 100:1179–1189 - PubMed
  13. Incrocci L, Wortel RC, Alemayehu WG et al (2016) Hypofractionated versus conventionally fractionated radiotherapy for patients with localised prostate cancer (HYPRO): final efficacy results from a randomised, multicentre, open-label, phase 3 trial. Lancet Oncol 17:1061–1069 - PubMed
  14. Arcangeli G, Saracino B, Gomellini S et al (2010) A prospective phase III randomized trial of hypofractionation versus conventional fractionation in patients with high-risk prostate cancer. Int J Radiat Oncol Biol Phys 78:11–18 - PubMed
  15. Murray JR, Tree AC, Alexander EJ et al (2020) Standard and hypofractionated dose escalation to intraprostatic tumor nodules in localized prostate cancer: efficacy and toxicity in the DELINEATE trial. Int J Radiat Oncol Biol Phys 106:715–724 - PubMed
  16. Kerkmeijer LGW, Groen VH, Pos FJ et al (2021) Focal boost to the intraprostatic tumor in external beam radiotherapy for patients with localized prostate cancer: results from the FLAME randomized phase III trial. J Clin Oncol 39(7):787–796 - PubMed
  17. Syndikus I, Cruickshank C, Staffurth J et al (2020) PIVOTALboost: a phase III randomised controlled trial of prostate and pelvis versus prostate alone radiotherapy with or without prostate boost (CRUK/16/018). Clin Transl Radiat Oncol 25:22–28 - PubMed
  18. Villeirs GM, Van Vaerenbergh K, Vakaet L et al (2005) Interobserver delineation variation using CT versus combined CT + MRI in intensity-modulated radiotherapy for prostate cancer. Strahlenther Onkol 181:424–430 - PubMed
  19. Horsley PJ, Aherne NJ, Edwards GV et al (2015) Planning magnetic resonance imaging for prostate cancer intensity-modulated radiation therapy: impact on target volumes, radiotherapy dose and androgen deprivation administration. Asia Pac J Clin Oncol 11:15–21 - PubMed
  20. Salambier C, Villeirs G, De Bari B et al (2018) ESTRO ACROP consensus guideline on CT- and MRI-based target volume delineation for primary radiation therapy of localized prostate cancer. Radiother Oncol 127:49–61 - PubMed
  21. McLaughlin PW, Evans C, Feng M et al (2010) Radiographic and anatomic basis for prostate contouring errors and methods to improve prostate contouring accurcy. Int J Radiat Oncol Biol Phys 76:369–378 - PubMed
  22. Hofman MS, Lawrentschuk N, Francis RJ et al (2020) Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study. Lancet 395:1208–1216 - PubMed
  23. Hayden AJ, Martin JM, Kneebone AB et al (2010) Australian & New Zealand Faculty of Radiation Oncology Genito-Urinary Group: 2010 consensus guidelines for definitive external beam radiotherapy for prostate carcinoma. J Med Imaging Radiat Oncol 54:513–525 - PubMed
  24. Roach M, Marquez C, Yuo HS et al (1994) Predicting the risk of lymph node involvement using the pre-treatment prostate specific antigen and gleason score in men with clinically localized prostate cancer. Int J Radiat Oncol Biol Phys 28:33–37 - PubMed
  25. Partin AW, Kattan MW, Subong ENP et al (2004) Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer—a multi-institutional update. Aktuelle Urol 35:377–378 - PubMed
  26. Ghadjar P, Fiorino C, Munck Af Rosenschöld P, Pinkawa M, Zilli T, van der Heide UA (2019) ESTRO ACROP consensus guideline on the use of image guided radiation therapy for localized prostate cancer. Radiother Oncol 141:5–13 - PubMed
  27. Wilkins A, Naismith O, Brand D et al (2020) Derivation of dose/volume constraints for the anorectum from clinician- and patient-reported outcomes in the CHHiP trial of radiation therapy fractionation. Int J Radiat Oncol Biol Phys 106:928–938 - PubMed
  28. Vassis S, Nöldeke B, Christiansen H, von Klot CA, Merten R (2020) Moderately HRT vs. CRT for localized prostate cancer using image-guided VMAT with SIB: evaluation of acute and late toxicities. Strahlenther Onkol 196:598–607 - PubMed
  29. Schörghofer A, Groher M, Karner J et al (2019) Risk-adapted moderate hypofractionation of prostate cancer: a prospective analysis of acute toxicity, QOL and outcome in 221 patients. Strahlenther Onkol 195:894–901 - PubMed
  30. Tamihardja J, Schortmann M, Lawrenz I et al (2021) Moderately hypofractionated radiotherapy for localized prostate cancer: updated long-term outcome and toxicity analysis. Strahlenther Onkol 197:124–132 - PubMed
  31. Moore A, Stav I, Den RB et al (2019) The financial impact of hypofractionated radiation for localized prostate cancer in the United States. J Oncol. https://doi.org/10.1155/2019/8170428 - PubMed

Publication Types