Practice patterns for post-prostatectomy hormonal therapy amongst Canadian radiation oncologists

Area of Science:

• Oncology
• Radiation Oncology
• Urology

Background:

• Postoperative radiotherapy (PORT) benefits pT3 disease and positive margins.
• The role of androgen deprivation therapy (ADT) after PORT requires further definition.
• Canadian radiation oncologists' current practices regarding ADT post-PORT were assessed.

Purpose of the Study:

• To determine factors influencing Canadian radiation oncologists' current use of ADT after PORT.
• To assess variations in prescribing ADT based on disease prognosticators and timing of PORT.

Main Methods:

• An institutional survey was emailed to the Genito-urinary Radiation Oncologists Group of Canada (GUROC).
• The survey assessed likelihood of prescribing ADT in early and delayed PORT scenarios.
• Descriptive statistics were used for analysis of survey responses.

Main Results:

• Most (94%) do not routinely advocate ADT with PORT.
• Gleason score, pT3b disease, and D'Amico category were key considerations for early PORT with undetectable PSA.
• PSA doubling time, high-risk disease, pT3b category, and time to relapse influenced decisions for early PORT with detectable PSA.

Conclusions:

• Significant variation exists in factors and duration considered for ADT with PORT.
• There is a clear need for consensus guidelines on ADT use after PORT.
• Findings support ongoing phase III trials investigating ADT in this setting.