Adjuvant and Salvage Radiation Therapy after Prostatectomy: Investigating Beliefs and Practices of Radiation Oncologists

Evidence regarding adjuvant and salvage radiation therapy RT (ART, SRT) following radical prostatectomy (RP) for prostate cancer is inconsistent. Study objectives were to collect survey information on Italian radiation oncologists' (RO) beliefs regarding the use of ART and SRT following RP and to compare results of Italian RO to those of American RO available from an analogous survey.

A modified version of a United States-based questionnaire captured attitudes and clinical approaches regarding post-RP RT of all 716 RO practicing in 147 radiation-oncology centers in Italy. Bivariate analyses compared the responses of Italian RO with those of American RO retrieved from a previously published study.

Analyzable questionnaires were completed by 153 Italian RO (response rate, 21%). Variations in practice were found for RT use, timing, dosage and technique. All Italian RO supported ART use, although factors influencing the decision to initiate ART varied. Most (81%) would wait 3-6 months after surgery before beginning RT. Compared to Italian RO, more American RO believed ART improves survival outcomes (70% vs. 35%, p

Italian RO strongly supported ART, but their approach to patient selection for ART and SRT varied. Striking differences between Italian and American RO regarding ART and SRT practices were found. Advance in knowledge: Differential RT practices and perceptions exist among RO internationally. Clinical studies must inform evidence-based guidelines to harmonize the use of post-RP RT.

The British journal of radiology. 2015 Sep 22 [Epub ahead of print]

Marco Lupattelli, Matthew Alcusky, Cynthia Aristei, Rita Bellavita, Barbara Alicja Jereczek-Fossa, John McAna, Timothy N Showalter, Vittorio Maio

1 Radiation Oncology Center, Perugia General Hospital, Perugia, Italy. , 2 College of Population Health, Thomas Jefferson University, Philadelphia, PA. , 3 Radiation Oncology Section, Department of Surgery and Biomedical Sciences, University of Perugia and Perugia General Hospital, Perugia, Italy. , 1 Radiation Oncology Center, Perugia General Hospital, Perugia, Italy. , 4 Department of Radiotherapy, European Institute of Oncology, Università degli Studi di Milano, Milan, Italy. , 2 College of Population Health, Thomas Jefferson University, Philadelphia, PA. , 5 Radiation Oncology, University of Virginia Health System, Charlottesville, VA. , 2 College of Population Health, Thomas Jefferson University, Philadelphia, PA.

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