title: Management of prostate cancer patients following radiation therapy after radical surgery referred from urology to radiation oncology departments in Spain.
abstract: OBJECTIVE
  To define usual clinical management of prostate cancer (PCa) patients following postoperative radiation therapy (RT) (adjuvant or salvage) and its evolution over time in radiation oncology (RO) departments in Spain.
  
  
  METHODS
  An epidemiological, cross-sectional, multicentre study was conducted. 567 PCa patients that had undergone radical prostatectomy (RP) and received postoperative RT between February and December of both 2006 and 2011 participated in the study. In patients from 2006, health-related quality of life (HRQoL) was assessed using the EPIC questionnaire. Investigators completed a specific survey on two clinical cases of adjuvant and salvage RT.
  
  
  RESULTS
  70.6 % of patients received salvage RT versus 29.4 % who received adjuvant RT; no significant differences were found in terms of frequency for each procedure between both the years. Regarding the survey, a positive surgical margin was the main criteria used in adjuvant RT decision making. In terms of salvage RT scenario, 85.7 % of the investigators stated that adjuvant RT should have been offered instead, 81.4 % of the investigators agreed on a PSA score >0.2 ng/mL as the main criteria for identifying biochemical recurrence after RP, and 67.4 % of investigators did not consider any PSA score for ruling out salvage RT treatment.
  
  
  CONCLUSIONS
  Most patients are referred to RO departments to receive salvage RT. Despite the publication of three IA evidence level randomized clinical trials, the patterns for using adjuvant and salvage RT did not change from 2006 to 2011, although patients' profile did. A consensus regarding postoperative RT indications should be reached in order to correct this controversial situation.
authors.affiliation: Servicio de Oncología Radioterápica Hospital Universitario de Santiago de Compostela, Tr. Choupana s/n, Compostela, Spain. Antonio.Gomez.Caamano@sergas.es.
authors.forename: A
authors.initials: A
authors.lastname: Gómez Caamaño
authors.affiliation: H. Universitario de La Princesa de Madrid, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Zapatero
authors.affiliation: H. General Universitario de Valencia, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: López Torrecilla
authors.affiliation: H. Universitari Vall d'Hebron de Barcelona, Barcelona, Spain.
authors.forename: X
authors.initials: X
authors.lastname: Maldonado
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D011788:Quality of Life; D018787:Radiation Oncology / Q000379:methods / Q000592:standards*; D018714:Radiotherapy, Adjuvant / Q000379:methods / Q000706:statistics & numerical data*; D012017:Referral and Consultation; D016879:Salvage Therapy / Q000379:methods / Q000706:statistics & numerical data*; D013030:Spain; D011795:Surveys and Questionnaires; D014572:Urology
keywords: Adjuvant; Prostate cancer; Prostatectomy; Radiation therapy; Salvage