Elmali Aysenur, Demirhan Birhan, Esen Caglayan Selenge Beduk, Guler Ozan Cem, Hurmuz Pervin, Onal Cem
Department of Radiation Oncology, Baskent University Faculty of Medicine, Ankara, 06490, Turkiye.
Division of Radiation Oncology, Iskenderun Gelisim Hospital, Hatay, 31200, Turkiye.
Can J Urol. 2025 Aug 29;32(4):243-254. doi: 10.32604/cju.2025.066700.
Intermediate-risk prostate cancer (IR-PC) represents a heterogeneous group requiring nuanced treatment approaches, and recent advancements in radiotherapy (RT), androgen deprivation therapy (ADT), and prostate-specific membrane antigen positron emission tomography (PSMA-PET/CT) imaging have prompted growing interest in personalized, risk-adapted management strategies. This study by the Turkish Society for Radiation Oncology aims to examine radiation oncologists' practices in managing IR-PC, focusing on RT and imaging modalities to identify trends for personalized treatments.
A cross-sectional survey was conducted among Turkish radiation oncologists treating at least 50 prostate cancer (PC) cases annually. The 22-item questionnaire covered IR-PC management aspects such as risk stratification, imaging preferences, androgen deprivation therapy (ADT) use and duration, RT techniques, and treatment combinations. Anonymous responses were analyzed using descriptive statistics.
Thirty radiation oncologists participated, 57% with over 20 years of experience. The median annual number of PC cases treated was 130. For risk stratification, 43% followed the National Comprehensive Cancer Network (NCCN) guidelines, while 30% used the D'Amico classification. Imaging preferences revealed 47% favored PSMA-PET/CT. External beam RT was universally preferred, with 60% adopting ultra-hypofractionation. ADT was used by 97%, with 73% recommending it for unfavorable IR-PC cases. Short-term ADT (4-6 months) was the standard, administered concurrently with RT by 57%. Cardiovascular status influenced decisions for 97% of respondents, while 37% also considered patient age, preferences, and sexual health.
This national survey demonstrates a shift toward personalized care in intermediate-risk prostate cancer in Turkey, marked by selective PSMA-PET/CT use, tailored ADT, and evolving radiotherapy practices. The findings underscore the importance of multidisciplinary collaboration-particularly between urologists and radiation oncologists-to optimize imaging integration and treatment outcomes.
中危前列腺癌（IR-PC）是一组异质性疾病，需要细致入微的治疗方法，放疗（RT）、雄激素剥夺治疗（ADT）以及前列腺特异性膜抗原正电子发射断层扫描（PSMA-PET/CT）成像技术的最新进展引发了人们对个性化、风险适应性管理策略的浓厚兴趣。土耳其放射肿瘤学会开展的这项研究旨在调查放射肿瘤学家在管理IR-PC方面的实践情况，重点关注放疗和成像方式，以确定个性化治疗的趋势。
对土耳其每年治疗至少50例前列腺癌（PC）病例的放射肿瘤学家进行横断面调查。这份包含22个条目的问卷涵盖了IR-PC管理的各个方面，如风险分层、成像偏好、雄激素剥夺治疗（ADT）的使用及持续时间、放疗技术和治疗组合。使用描述性统计分析匿名回复。
30名放射肿瘤学家参与了调查，其中57%拥有超过20年的经验。每年治疗的PC病例中位数为130例。在风险分层方面，43%遵循美国国立综合癌症网络（NCCN）指南，而30%使用达米科分类法。成像偏好显示，47%的人青睐PSMA-PET/CT。外照射放疗普遍受到青睐，60%的人采用超分割放疗。97%的人使用ADT，73%的人建议在预后不良的IR-PC病例中使用。短期ADT（4 - 6个月）是标准做法，57%的人将其与放疗同时进行。97%的受访者表示心血管状况会影响决策，37%的人还会考虑患者年龄、偏好和性健康状况。
这项全国性调查表明，土耳其在中危前列腺癌的治疗上正朝着个性化护理转变，其特点是选择性使用PSMA-PET/CT、量身定制ADT以及不断发展的放疗实践。研究结果强调了多学科协作的重要性，尤其是泌尿外科医生和放射肿瘤学家之间的协作，以优化成像整合和治疗效果。
