Kaljouw Emmie, Pieters Bradley R, Kovács György, Hoskin Peter J
Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands.
Radiother Oncol. 2016 Jan;118(1):122-30. doi: 10.1016/j.radonc.2015.10.021. Epub 2015 Nov 5.
Patients treated with low radiotherapy dose or treated at young age are at a risk of developing local relapse. Although data are preliminary, brachytherapy seems an attractive treatment option for recurrent prostate cancer after previous radiotherapy. Therefore, the UroGEC group of the GEC-ESTRO conducted a Delphi study, to explore expert opinion on the management of salvage prostate brachytherapy.
For this study, a series of digital questionnaires were sent, which enabled data collection from an international group of experienced participants. Consensus was defined as 80% agreement for each question.
Eighteen experts completed all rounds of the Delphi study. After the final round consensus was reached on 17 out of 38 (45%) questions. Consensus was reached in 52% of questions about patient selection, in 50% of the questions about diagnostic tests and in 22% of the questions on performing salvage prostate brachytherapy.
The group was able to find consensus on less than half of the questions. Most consensus was reached on topics involving patient selection and diagnostic tests, where participants could build on their experience of daily practice. However, the way to perform the salvage treatment is less established and results in more disagreement between participants.
接受低剂量放射治疗或年轻时接受治疗的患者有局部复发的风险。尽管数据尚属初步,但近距离放射治疗似乎是既往放疗后复发性前列腺癌的一种有吸引力的治疗选择。因此,GEC-ESTRO的泌尿生殖系统肿瘤协作组开展了一项德尔菲研究,以探讨关于挽救性前列腺近距离放射治疗管理的专家意见。
在本研究中,发放了一系列数字问卷,从而能够从一组国际经验丰富的参与者中收集数据。共识定义为每个问题有80%的一致意见。
18位专家完成了德尔菲研究的所有轮次。在最后一轮后,38个问题中有17个(45%)达成了共识。在关于患者选择的问题中,52%达成了共识;在关于诊断检查的问题中,50%达成了共识;在关于进行挽救性前列腺近距离放射治疗的问题中,22%达成了共识。
该小组在不到一半的问题上达成了共识。在涉及患者选择和诊断检查的主题上达成的共识最多,参与者可以基于他们的日常实践经验。然而,挽救性治疗的实施方式尚未完全确立,导致参与者之间存在更多分歧。