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Objective <p>The management of high-risk (HR) prostate cancer represents a challenge for radiation oncologists. This survey investigates the pattern of care in management of HR-prostate cancer across Spanish institutions.</p> Materials and methods <p>We conducted a survey among URONCOR members from March to May 2024. This survey was structured in five sections: diagnosis, radiotherapy, hormonal treatment, follow-up, and future perspectives.</p> Results <p>A total of 74 responses from 71 different hospitals were received. Participants have a median professional experienced of 11&#xa0;years, working most of them (84.9%) in public university hospitals. 97.3% have multidisciplinary tumor board and treat a median of 50 (0–200) HR-prostate cancer patients per year/department. 44.63% of centers use Choline-PET and 28.4% PSMA-PET at diagnosis with 26 different fractionation schedules, the most common is moderate hypofractionation (52.7%): 70&#xa0;Gy in 28 fractions, followed by 37.5&#xa0;Gy in 15 fractions + 15&#xa0;Gy brachytherapy boost (30.4%). 56.8% of the institutions perform whole-pelvic irradiation in N0 patients, with 50.4&#xa0;Gy in 28 fractions (40.48%) being the most common scheme. 56.8% prescribe an LHRH agonist and 74.6% for 24&#xa0;months. 75.7% prescribe abiraterone in very high-risk patients. 63.0% use the PHOENIX-criteria to define a recurrence. 38.0% perform PSMA-PET and 39.0% Choline-PET as imaging for recurrence. After local relapse, 73.97% apply a re-irradiation technique with 11 different schedules (32.35%), with HDR-brachytherapy: 13.5&#xa0;Gy × 2 being the most used (56.16%). 83.8% consider that they achieved good results in HR-prostate cancer.</p> Conclusion <p>This study represents the current status of the management of HR-prostate cancer in Spain, highlighting the wide variety of radiotherapy treatments as well as the need for national consensus guidelines.</p>

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Management of high-risk prostate cancer in Spain: results from a national patterns of care survey

  • 期刊论文

  • 发表日期：

    2025年10月29日

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  • Victor Duque-Santana,
  • Maria Antonia Gómez-Aparicio,
  • Abrahams Ocanto,
  • Elias Gomis Selles,
  • Miren Gaztañaga,
  • Patricia Willisch,
  • Xavier Maldonado Pijoan,
  • Manuel Luis Blanco-Villar,
  • Ivan Henriquez,
  • Pedro Carlos Lara,
  • Ivone Ribeiro,
  • Alai Goñi Ramirez,
  • Marta López Valcárcel,
  • Ignacio Visus Fernández de Manzanos,
  • Susana Pérez Echagüen,
  • Pilar Alonso Martínez,
  • Victoria Vera Barragán,
  • Carmen Velilla Millán,
  • Ana Illescas Vacas,
  • Pilar María Samper Ots,
  • Luis Alberto Glaría Enríquez,
  • Angel Montero Luis,
  • Laura Montezuma Niño,
  • Rocío del Castillo Acuña,
  • Elísabet González Del Portillo,
  • Ferran Ferrer,
  • Alfonso Gómez-Iturriaga,
  • Antonio José Conde Moreno,
  • Elia Del Cerro Peñalver,
  • Felipe Couñago,
  • Fernando López-Campos

摘要

Objective

The management of high-risk (HR) prostate cancer represents a challenge for radiation oncologists. This survey investigates the pattern of care in management of HR-prostate cancer across Spanish institutions.

Materials and methods

We conducted a survey among URONCOR members from March to May 2024. This survey was structured in five sections: diagnosis, radiotherapy, hormonal treatment, follow-up, and future perspectives.

Results

A total of 74 responses from 71 different hospitals were received. Participants have a median professional experienced of 11 years, working most of them (84.9%) in public university hospitals. 97.3% have multidisciplinary tumor board and treat a median of 50 (0–200) HR-prostate cancer patients per year/department. 44.63% of centers use Choline-PET and 28.4% PSMA-PET at diagnosis with 26 different fractionation schedules, the most common is moderate hypofractionation (52.7%): 70 Gy in 28 fractions, followed by 37.5 Gy in 15 fractions + 15 Gy brachytherapy boost (30.4%). 56.8% of the institutions perform whole-pelvic irradiation in N0 patients, with 50.4 Gy in 28 fractions (40.48%) being the most common scheme. 56.8% prescribe an LHRH agonist and 74.6% for 24 months. 75.7% prescribe abiraterone in very high-risk patients. 63.0% use the PHOENIX-criteria to define a recurrence. 38.0% perform PSMA-PET and 39.0% Choline-PET as imaging for recurrence. After local relapse, 73.97% apply a re-irradiation technique with 11 different schedules (32.35%), with HDR-brachytherapy: 13.5 Gy × 2 being the most used (56.16%). 83.8% consider that they achieved good results in HR-prostate cancer.

Conclusion

This study represents the current status of the management of HR-prostate cancer in Spain, highlighting the wide variety of radiotherapy treatments as well as the need for national consensus guidelines.