Urologists' referral and radiation oncologists' treatment patterns regarding high-risk prostate cancer patients receiving radiotherapy within 6 months after radical prostatectomy: A prospective cohort analysis.
Adult
Aged
Australia
Cohort Studies
Humans
Male
Middle Aged
Practice Patterns, Physicians'
/ statistics & numerical data
Prostatectomy
Prostatic Neoplasms
/ radiotherapy
Radiation Oncologists
/ statistics & numerical data
Radiotherapy, Adjuvant
Referral and Consultation
/ statistics & numerical data
Risk
Urologists
/ statistics & numerical data
adjuvant radiotherapy
prostate cancer
radiation oncologists
referral
urologists
Journal
Journal of medical imaging and radiation oncology
ISSN: 1754-9485
Titre abrégé: J Med Imaging Radiat Oncol
Pays: Australia
ID NLM: 101469340
Informations de publication
Date de publication:
Feb 2020
Feb 2020
Historique:
received:
20
06
2019
accepted:
16
10
2019
pubmed:
4
12
2019
medline:
15
12
2020
entrez:
4
12
2019
Statut:
ppublish
Résumé
Previous studies have observed low rates of adjuvant radiotherapy after radical prostatectomy (RP) for high-risk prostate cancer patients. However, it is not clear the extent to which these low rates are driven by urologists' referral and radiation oncologists' treatment patterns. The Clinician-Led Improvement in Cancer Care (CLICC) implementation trial was conducted in nine public hospitals in New South Wales, Australia. Men who underwent RP for prostate cancer during 2013-2015 and had at least one high-risk pathological feature of extracapsular extension, seminal vesicle invasion and/or positive surgical margins were included in these analyses. Outcomes were as follows: (i) referral to a radiation oncologist within 4 months after RP ('referred'); (ii) commencement of radiotherapy within 6 months after RP among those who consulted a radiation oncologist ('radiotherapy after consultation'). Three hundred and twenty-five (30%) of 1071 patients were 'referred', and 74 (61%) of 121 patients received 'radiotherapy after consultation'. Overall, the probability of receiving radiotherapy within 6 months after RP was 15%. The probability of being 'referred' increased according to higher 5-year risk of cancer-recurrence (P < 0.001). Only 30% of patients with high-risk features are referred to a radiation oncologist with the likelihood of referral being influenced by the perceived risk of cancer-recurrence as well as the urologist's institutional/personal preference. When patients are seen by a radiation oncologist, 61% receive radiotherapy within 6 months after RP with the likelihood of receiving radiotherapy not being heavily influenced by increasing risk of recurrence. This suggests many suitable patients would receive radiotherapy if referred and seen by a radiation oncologist.
Identifiants
pubmed: 31793211
doi: 10.1111/1754-9485.12979
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
134-143Subventions
Organisme : National Health and Medical Research Council
ID : 1011474
Organisme : Prostate Cancer Foundation of Australia
ID : NHMRC partnership project grant scheme
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2019 The Royal Australian and New Zealand College of Radiologists.
Références
Wiegel T, Bartkowiak D, Bottke D et al. Adjuvant radiotherapy versus wait-and-see after radical prostatectomy: 10-year follow-up of the ARO 96-02/AUO AP 09/95 trial. Eur Urol 2014; 66: 243-50.
Bolla M, van Poppel H, Tombal B et al. Postoperative radiotherapy after radical prostatectomy for high-risk prostate cancer: long-term results of a randomised controlled trial (EORTC trial 22911). The Lancet. 2012; 380: 2018-27.
Thompson IM, Tangen CM, Paradelo J et al. Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial. J Urol 2009; 181: 956-62.
Mottet N, Bellmunt J, Bolla M et al. EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 2017; 71: 618-29.
Thompson IM, Valicenti RK, Albertsen P et al. Adjuvant and salvage radiotherapy after prostatectomy: AUA/ASTRO Guideline. J Urol 2013; 190: 441-9.
Australian Cancer Network Management of Metastatic Prostate Cancer Working Group. Clinical Practice Guidelines for the Management of Locally Advanced and Metastatic Prostate Cancer. Cancer Council Australia and Australian Cancer Network, Sydney, 2010. Available at: https://www.andrologyaustralia.org/wp-content/uploads/FINAL_Advanced_Prostate_Cancer_Guidelines.pdf Accessed February 2018
Sineshaw HM, Gray PJ, Efstathiou JA, Jemal A. Declining use of radiotherapy for adverse features after radical prostatectomy: results from the National Cancer Data Base. Eur Urol 2015; 68: 768-74.
Schreiber D, Rineer J, Yu JB et al. Analysis of pathologic extent of disease for clinically localized prostate cancer after radical prostatectomy and subsequent use of adjuvant radiation in a national cohort. Cancer 2010; 116: 5757-66.
Ghia AJ, Shrieve DC, Tward JD. Adjuvant radiotherapy use and patterns of care analysis for margin-positive prostate adenocarcinoma with extracapsular extension: postprostatectomy adjuvant radiotherapy: a SEER analysis. Urology 2010; 76: 1169-74.
Kalbasi A, Swisher-McClure S, Mitra N et al. Low rates of adjuvant radiation in patients with nonmetastatic prostate cancer with high-risk pathologic features. Cancer 2014; 120: 3089-96.
Daniels CP, Millar JL, Spelman T, Sengupta S, Evans SM. Predictors and rate of adjuvant radiation therapy following radical prostatectomy: a report from the Prostate Cancer Registry. J Med Imaging Radiat Oncol 2016; 60: 247-54.
Brown BB, Young J, Smith DP et al. Clinician-led improvement in cancer care (CLICC)-testing a multifaceted implementation strategy to increase evidence-based prostate cancer care: phased randomised controlled trial-study protocol. Implement Sci 2014; 9(1): 64.
Brown B, Young J, Smith DP et al. A multidisciplinary team-oriented intervention to increase guideline recommended care for high-risk prostate cancer: A stepped-wedge cluster randomised implementation trial. Implement Sci 2018; 13: 43.
Memorial Sloan Kettering Cancer Center. Dynamic prostate cancer nomogram: coefficients. https://www.mskcc.org/nomograms/prostate/post-op/coefficients
Pearse M, Fraser-Browne C, Davis ID et al. A Phase III trial to investigate the timing of radiotherapy for prostate cancer with high-risk features: Background and rationale of the Radiotherapy-Adjuvant Versus Early Salvage (RAVES) trial. BJU Int 2014; 113(S2): 7-12.
White IR, Royston P, Wood AM. Multiple imputation using chained equations: issues and guidance for practice. Stat Med 2011; 30(4): 377-99.
Arcangeli S, Ramella S, De Bari B, Franco P, Alongi F, D’Angelillo RM. A cast of shadow on adjuvant radiotherapy for prostate cancer: a critical review based on a methodological perspective. Crit Rev Oncol Hematol. 2016; 1: 322-7.
Brown B, Young J, Kneebone AB, Brooks AJ, Dominello A, Haines M. Knowledge, attitudes and beliefs towards management of men with locally advanced prostate cancer following radical prostatectomy: an Australian survey of urologists. BJU Int 2016; 117(S4): 35-44.
Brown B, Egger S, Young J et al. Changing attitudes towards management of men with locally advanced prostate cancer following radical prostatectomy: A follow-up survey of Australia-based urologists. J Med Imaging Radiat Oncol 2016; 60: 744-55.
Showalter TN, Ohri N, Teti KG et al. Physician beliefs and practices for adjuvant and salvage radiation therapy after prostatectomy. Int J Radiat Oncol Biol Phys 2012; 82: e233-8.
Kim SP, Tilburt JC, Karnes RJ et al. Variation in treatment recommendations of adjuvant radiation therapy for high-risk prostate cancer by physician specialty. Urology 2013; 82: 807-13.
Van Cangh PJ, Richard F, Lorge F et al. Adjuvant radiation therapy does not cause urinary incontinence after radical prostatectomy: results of a prospective randomized study. J Urol 1998; 159: 164-6.
Moinpour CM, Hayden KA, Unger JM et al. Health-related quality of life results in pathologic stage C prostate cancer from a Southwest Oncology Group trial comparing radical prostatectomy alone with radical prostatectomy plus radiation therapy. J Clin Oncol 2008; 26: 112-120.
Feng M, Hanlon AL, Pisansky TM et al. Predictive factors for late genitourinary and gastrointestinal toxicity in patients with prostate cancer treated with adjuvant or salvage radiotherapy. Int J Radiat Oncol Biol Phys 2007; 68: 1417-23.
Landoni V, Fiorino C, Cozzarini C, Sanguineti G, Valdagni R, Rancati T. Predicting toxicity in radiotherapy for prostate cancer. Phys Med 2016; 32: 521-32.
Quon H, Suderman D, Guilbert K et al. Population-based referrals for adjuvant radiotherapy after radical prostatectomy in men with prostate cancer: impact of randomized trials. Clin Genitourin Cancer 2014; 12: e1-5.
Rothman KJ, Gallacher JE, Hatch EE. Why representativeness should be avoided. Int J Epidemiol. 2013; 42: 1012-4.
Mealing NM, Banks E, Jorm LR, Steel DG, Clements MS, Rogers KD. Investigation of relative risk estimates from studies of the same population with contrasting response rates and designs. BMC Med Res Methodol. 2010; 10: 26.
Hoffman KE, Nguyen PL, Chen MH et al. Recommendations for post-prostatectomy radiation therapy in the United States before and after the presentation of randomized trials. J Urol 2011; 185(1): 116-20.
Parker C, Sydes MR, Catton C et al. Radiotherapy and androgen deprivation in combination after local surgery (RADICALS): a new Medical Research Council/National Cancer Institute of Canada phase III trial of adjuvant treatment after radical prostatectomy. BJU Int 2007; 99(6): 1376-9.
Richaud P, Sargos P, de Figueiredo Henriques et al. Postoperative radiotherapy of prostate cancer. Cancer Radiother 2010; 14: 500-3.