Malinverni Giuseppe, Greco Carlo, Bianchi Pieromaria, Busutti Luciano, Cagna Emanuela, Cozzarini Cesare, Del Duca Massimo, Franzone Paola, Frezza Giovanni, Gabriele Pietro, Genovesi Domenico, Girelli Giuseppe Franco, Italia Corrado, Mandoliti Giovanni, Mauro Floranna, Nava Simonetta, Pratissoli Silvia, Saracino Maria Bianca, Squillace Luigi, Signor Marco, Tagliagambe Angiolo, Vavassori Vittorio, Villa Sergio, Zini Giampaolo, Valdagni Riccardo
AIRO (Associazione Italiana Radioterapia Oncologica) National Working Group on Prostate Radiotherapy, IRCC, Institute for Cancer Research and Treatment, Candiolo (Turin), Italy.
Tumori. 2005 Mar-Apr;91(2):156-62. doi: 10.1177/030089160509100210.
The National Working Group on Prostate Radiotherapy of AIRO (Associazione Italiana Radioterapia Oncologica, Italian Association of Radiotherapeutic Oncology) was established in March 2001. A retrospective multi-center survey was performed to analyze the patterns of care for prostate cancer patients treated with postoperative radiotherapy following radical prostatectomy in Italy with regard to the year 2000.
A structured questionnaire was mailed to 47 Italian radiotherapy centers to assess patient accrual in the postoperative setting in the interval comprised between period January-December 2000. Numbers of patients treated for different stages, specific prognostic factors indicating the need for adjuvant radiotherapy, fractionation schedules and prescription doses were acquired as well as other clinically important factors such as radiotherapy timing and the use of hormone therapy. More technical features of the treatment, such as patient positioning, mode of simulation, typical field setup and dose prescription criteria were also included in the questionnaire.
The questionnaire was returned by 24 radiotherapy Institutions (51%) with a total number of 470 patients treated postoperatively in the year 2000. An average of about 20 patients were enrolled by each radiotherapy center. The age range was 45-81 years. Radiotherapy was delivered within 6 months of radical prostatectomy in 297 patients (65.4%) (mean, 3.4 months). In 157 (34.6%), the treatment was delivered as a salvage approach for biochemical or micro-macroscopic recurrence. Most of patients had locally advanced stage disease (pT3-pT4) (76%). Unfavorable prognostic factors, such as positive margins, capsular invasion, Gleason pattern score > 7 were present in about 50% of patients.
The study confirmed that important risk factors for recurrences are present in a significant percentage of patients treated by radical prostatectomy. The number of patients that would benefit from adjuvant radiotherapy is therefore potentially very large. Future prospective studies should be conducted to assess and to clarify the respective roles of adjuvant and salvage radiotherapy in prostate cancer patients.
意大利放射肿瘤治疗协会（AIRO）前列腺放疗国家工作组于2001年3月成立。开展了一项回顾性多中心调查，以分析2000年意大利前列腺癌患者根治性前列腺切除术后接受术后放疗的治疗模式。
向47个意大利放疗中心邮寄了一份结构化问卷，以评估2000年1月至12月期间术后患者的入组情况。获取了不同分期接受治疗的患者数量、表明需要辅助放疗的特定预后因素、分割方案和处方剂量，以及其他临床重要因素，如放疗时机和激素治疗的使用情况。问卷还包括治疗的更多技术特征，如患者体位、模拟方式、典型野设置和剂量处方标准。
24个放疗机构（51%）回复了问卷，2000年共有470例患者接受了术后放疗。每个放疗中心平均入组约20例患者。年龄范围为45 - 81岁。297例患者（65.4%）在根治性前列腺切除术后6个月内接受了放疗（平均3.4个月）。157例患者（34.6%）接受了挽救性放疗，用于生化或微观 - 宏观复发。大多数患者患有局部晚期疾病（pT3 - pT4）（76%）。约50%的患者存在不良预后因素，如切缘阳性、包膜侵犯、Gleason评分>7。
该研究证实，在接受根治性前列腺切除术的患者中，相当比例的患者存在复发的重要危险因素。因此，可能从辅助放疗中获益的患者数量潜在非常大。未来应开展前瞻性研究，以评估和明确辅助放疗和挽救性放疗在前列腺癌患者中的各自作用。
