Treatment paths for localised prostate cancer in Italy: The results of a multidisciplinary, observational, prospective study (Pros-IT CNR)

Abstract

BackgroundThere are several treatments available to newly diagnosed prostate cancer (PCA) patients. Although surgery and radiotherapy (RT) with or without androgen deprivation therapy (ADT) are widely adopted treatment options for localized PCA together with active surveillance (AS), there is no consensus nor randomised trials on treatment selection, prospective quality of life (QOL), along with toxicity outcomes and according to treatment modality in the Italian population. The current study aimed to describe clinical-therapeutic features and QOL at PCA diagnosis, according to different treatment patterns in a large prospective, Italian population, enrolled in the Pros-IT CNR study.MethodsThe Pros-IT CNR is an on-going national, multicenter, observational, prospective study on patients affected by PCA who have been referred by 97 Italian Urology, Radiation Oncology and Medical Oncology facilities participating in the project. The possible relationships between the treatment patterns reported in the 6 month follow-up case report form and patients’ features at diagnosis were evaluated using exploratory multiple correspondence analysis (MCA) and other data analysis method.ResultsAt diagnosis, surgery and AS patients were significantly younger, had fewer comorbidities, lower PSA levels and Gleason Score (GS) values; they were also diagnosed at an earlier stage of disease with respect to the RT or ADT patients who showed significantly worse QoL scores at the time of diagnosis.ConclusionsAn analysis of the data collected at baseline and 6 months later uncovered substantial differences in ages, comorbidities, clinical and QOL features in the various treatment groups. These findings do not fully reflect the current PCA treatment guidelines and suggest the need for a multidisciplinary consensus guideline to ameliorate both the counselling and treatments of PCA patients.

How Has Prostate Cancer Radiotherapy Changed in Italy between 2004 and 2011? An Analysis of the National Patterns-Of-Practice (POP) Database by the Uro-Oncology Study Group of the Italian Society of Radiotherapy and Clinical Oncology (AIRO)

“…Surgery and RT can both be considered standard treatments for localized PCa [ 13 , 14 , 15 , 16 ]. In Italy, however, surgery still remains the most frequently used therapeutic approach for localized malignancies, especially for younger patients and those without relevant comorbidities [ 17 ]. From a radiation oncologists’ perspective, recent technological innovations and the results of dose escalation studies [ 18 , 19 , 20 , 21 , 22 ] have led to a significant change in PCa treatment.…”

Impact of Gastrointestinal Side Effects on Patients’ Reported Quality of Life Trajectories after Radiotherapy for Prostate Cancer: Data from the Prospective, Observational Pros-IT CNR Study

“…Radiotherapy (RT) represents an important therapeutic option for the treatment of localized prostate cancer (PCa), as was also confirmed in recently published on-going prospective studies investigating patterns of practice and related toxicities [ 1 , 2 ]. The choice between RT and surgery may depend on different variables (such as comorbidities, risk of toxicities, patient preference and/or life expectancy) and cancer features so that the definitive adoption of a therapeutic option need to be accompanied by complete information about advantages and side effects of each choice, particularly about urinary, bowel, and sexual function [ 3 ].…”

Volumetric-Modulated Arc Radiotherapy with Daily Image-Guidance Carries Better Toxicity Profile for Higher Risk Prostate Cancer

“…Image-Guidance Carries Better Toxicity Profile for Higher Risk Prostate Cancer receiving definitive RT tend to be relatively older with increased comorbidity burden compared to RP candidates, as reported in multiple population-based studies (Buglione et al, 2019;Daskivich et al, 2013).…”