PROACTA: a survey on the actual attitude of the Italian radiation oncologists in the management and prescription of horm
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RADIOTHERAPY
PROACTA: a survey on the actual attitude of the Italian radiation oncologists in the management and prescription of hormonal therapy in prostate cancer patients Sergio Fersino1 · Simona Borghesi2 · Barbara Alicja Jereczek‑Fossa3,4 · Stefano Arcangeli5 · Gianluca Mortellaro6 · Stefano Maria Magrini7 · Filippo Alongi8,9 on behalf of Uro-Oncology study group of Italian association of Radiotherapy and Clinical Oncology (AIRO) Received: 5 December 2019 / Accepted: 12 August 2020 © Italian Society of Medical Radiology 2020
Abstract Aim To investigate the actual attitude of Radiation Oncologists in the prescription of hormonal therapy in prostate cancer (PC) with or without Radiation Therapy (RT). Materials and methods In 2019, a survey named Prescription of Radiation Oncologists ACtual Attitude including 18 items was sent to all Italian Radiation Oncologists of the Italian Association of Radiotherapy and Clinical Oncology. The first 4 items were about the Radiation Oncology Centers characteristics and years of practice of the respondents. The remaining 14 items concerned the setting in which hormone therapy was prescribed in PC patients (radical, postprostatectomy/oligometastatic state), the kind of drug, the choice modality (Multidisciplinary Group/autonomy decision) and other factors. Results A total of 127 questionnaires were returned, mainly by Northern Italy Radiation Oncology Centres (44.9%), and by experienced Radiation Oncologists (78%), who declared to prescribe independently hormone therapy in 85.8% of cases. The Androgen deprivation therapy (ADT) prescription in castration naive PC was made independently by 56.7% of respondents and associated with radical RT, postoperative or salvage RT according to various risk factors. In castration-sensitive oligorecurrent PC, the majority (51.2%) administered ADT only if local ablative treatment was not feasible, while in metastatic castration resistant disease novel hormone therapy use was established in almost half of cases within multidisciplinary board. Radiation Oncologists could prescribe these drugs independently in 64% of cases. Conclusion Our survey established the prescription attitude of ADT and new hormonal agents (abiraterone, enzalutamide, apalutamide) by Italian Radiation Oncologists and highlighted the importance of expertise in global PC management. Keywords Survey · Prostate cancer · Hormonal therapy · Radiotherapy
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UOC Radioterapia ASST Monza, Università di Milano, Bicocca, Italy
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Department of Radiation Oncology, ARNAS Ospedale Civico, Palermo, Italy
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Radiotherapy Unit‑ Ospedale S. Donato e Santa Maria alla Gruccia, Azienda USL Toscana Sud, Arezzo, Italy
Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
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Department of Oncology and Hemato‑Oncology, University of Milan, Milan, Italy
Advanced Radiation Oncology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar‑Verona, Italy
9
University of Brescia, Brescia, Italy
* Sergio Fersino [email protected]
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