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Multiparametric MRI for prostate cancer: a national survey of patterns of practice among radiation oncologists in Spain

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Abstract

Purpose

To investigate patterns of practice among Spanish radiation oncologists in the use of multiparametric magnetic resonance imaging (mpMRI) for the treatment of prostate cancer (PCa). We evaluated (1) access to mpMRI, (2) current clinical practices, and (3) physician expectations of mpMRI.

Methods

Cross-sectional survey of 118 radiation oncologists at 75 Radiation Oncology (RO) departments in Spain.

Results

A total of 55 radiation oncologists from 52 RO departments (52/75; 69%) completed the survey. Prostate mpMRI is performed at 94.5% of the centres that provided data. The most common indications for mpMRI in routine clinical practice were: (1) detection/localization of the tumour prior to second biopsy (82.7%), (2) cancer staging (80.8%), and (3) detection of recurrence after definitive treatment (80.8%). Most respondents (72.7%) reported modifying the primary radiotherapy treatment when mpMRI findings indicate a more advanced T stage with a resultant change in the risk group. Most respondents (90.5%) treat macroscopic local recurrence after prostatectomy with high doses, ranging from 71 to 83 Gy; in 37.7% of cases, the full dose is delivered to the entire prostate bed. In pelvic nodal recurrence, more than half (59.3%) of the respondents reported performing elective pelvic radiotherapy, including the prostate bed, with a boost to the involved nodes.

Conclusions

This survey shows that prostate mpMRI is routinely used by radiation oncologists in Spain in a wide range of clinical scenarios. The findings reported here underscore the need to standardize treatment protocols for definitive and salvage radiotherapy in patients evaluated with mpMRI.

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Acknowledgements

We thank all the participants in the study for helping to contribute to a greater understanding of the situation of mpMRI in Spain (the participating hospitals are listed in Online Resource 1). The authors would like to thank to Israel John Thuissard and David Sanz-Rosa for their support with the statistical analysis and creation of the figures in this manuscript. We thank Bradley Londres for his excellent work in translating and editing this manuscript.

Funding

The translation of this work was supported financially by the Spanish Society of Radiation Oncology.

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Authors and Affiliations

  1. Department of Radiation Oncology, Hospital Universitario Quirónsalud, Madrid, Universidad Europea de Madrid, Calle Diego de Velázquez, 2, Pozuelo de Alarcón, 28223, Madrid, Spain

    F. Couñago

  2. Department of Radiation Oncology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain

    G. Sancho

  3. Department of Radiation Oncology, Hospital Universitario Cruces, Biocruces Health Research Institute, Barakaldo, Spain

    A. Gómez-Iturriaga

  4. Department of Radiation Oncology, Hospital Universitario de Sant Joan, Institute d’Investigació Sanitaria Pere Virgili (IISPV), Reus, Spain

    I. Henríquez

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  1. F. Couñago
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The Urological Tumours Working Group of the Spanish Society of Radiation Oncology (URONCOR/SEOR)

Corresponding author

Correspondence to F. Couñago.

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All authors declared no conflicts of interest.

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Additional information

The Urological Tumours Working Group of the Spanish Society of Radiation Oncology (URONCOR/SEOR) members are given in the Online Appendix.

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Couñago, F., Sancho, G., Gómez-Iturriaga, A. et al. Multiparametric MRI for prostate cancer: a national survey of patterns of practice among radiation oncologists in Spain. Clin Transl Oncol 20, 1484–1491 (2018). https://doi.org/10.1007/s12094-018-1919-z

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  • DOI: https://doi.org/10.1007/s12094-018-1919-z

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