title: Practice patterns in the management of prostate cancer in Spain: results from a national survey among radiation oncologists in 2009.
abstract: BACKGROUND
  Little is known of practice patterns on advanced prostate cancer (PC) in Spain. The study objectives were to investigate practice patterns in the management of PC and to determine the adherence to the 2007 Spanish guidelines for the management of PC.
  
  
  METHODS
  An epidemiological, cross-sectional study was undertaken. Study-specific questionnaires were distributed to all centers with radiation oncology (RO) facilities delivering megavoltage radiation therapy (RT) in Spain (n = 108). A questionnaire evaluated diagnostic and treatment approaches to PC in low-risk and high-risk cases. And a 12-item questionnaire was used to assess guidelines adherence.
  
  
  RESULTS
  Responses were obtained from 102 centers (94.0 % response rate). In the high-risk scenario, the majority of clinicians (99.0 %) chose combined modality treatment with RT and androgen deprivation (AD) and 93.0 % recommended long-term AD. External-beam RT (EBRT) doses ranging 72-76 Gy were used in 59.5 % of centers and >76 Gy was employed in 40.5 %. In the low-risk scenario, EBRT was chosen by 59.6 %, brachytherapy by 39.4 %, and active surveillance by 1 %. The consensus was high (score 5 + 4 ≥ 90 %) on 8/12 questions assessing adherence to guidelines, being high specifically on items related to RT technique, RT dose, combination of HT and RT in intermediate/high-risk patients, and prognostic factors.
  
  
  CONCLUSIONS
  This is the largest survey to date of Spanish RO departments dealing with PC. The study results therefore likely provide a highly reliable picture of clinical practice in Spain in this century and show how this practice is influenced by clinical evidence from randomized trials and consensus conferences.
authors.affiliation: Department of Radiation Oncology, Health Research Institute IP, Hospital Universitario de la Princesa, Diego de León, 62, 28006, Madrid, Spain. azapatero.hlpr@salud.madrid.org
authors.forename: Almudena
authors.initials: A
authors.lastname: Zapatero
authors.forename: José
authors.initials: J
authors.lastname: López-Torrecilla
authors.forename: Ismael
authors.initials: I
authors.lastname: Herruzo
authors.forename: Felipe A
authors.initials: FA
authors.lastname: Calvo
mesh_terms: D000726:Androgen Antagonists / Q000627:therapeutic use*; D001918:Brachytherapy; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000628:therapy*; D018787:Radiation Oncology; D016879:Salvage Therapy
chemical_list: D000726:Androgen Antagonists