Management of prostate cancer radiotherapy during the COVID-19 pandemic: A necessary paradigm change.
Cancer Treat Res Commun
; 27: 100331, 2021.
Article
in English
| MEDLINE | ID: covidwho-1064990
ABSTRACT
PURPOSE:
To adapt the management of prostate malignancy in response to the COVID-19 pandemic.METHODS:
In according to the recommendations of the European Association of Urology, we have developed practical additional document on the treatment of prostate cancer.RESULTS:
Low-Risk Group Watchful Waiting should be offered to patients >75 years old, with a limited life expectancy and unfit for local treatment. In Active Surveillance (AS) patients re-biopsy, PSA evaluation and visits should be deferred for up to 6 months, preferring non-invasive multiparametric-MRI. The active treatment should be delayed for 6-12 months. Intermediate-Risk Group AS should be offered in favorable-risk patients. Short-course neoadjuvant androgen deprivation therapy (ADT) combined with ultra-hypo-fractionation radiotherapy should be used in unfavorable-risk patients. High-Risk Group Neoadjuvant ADT combined with moderate hypofractionation should be preferred. Whole-pelvis irradiation should be offered to patients with positive lymph nodes in locally advanced setting. ADT should be initiated if PSA doubling time is < 12 months in radio-recurrent patients, as well as in low priority/low volume of metastatic hormone sensitive prostate cancer. If radiotherapy cannot be delayed, hypo-fractionated regimens should be preferred. In high priority class metastatic disease, treatment with androgen receptor-targeted agents should be offered. When palliative radiotherapy for painful bone metastasis is required, single fraction of 8 Gy should be offered.CONCLUSIONS:
In Covid-19 Era, the challenge should concern a correct management of the oncologic patient, reducing the risk of spreading the virus without worsening tumor prognosis.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Prostatic Neoplasms
/
Radiation Dose Hypofractionation
/
SARS-CoV-2
/
COVID-19
/
Androgen Antagonists
Type of study:
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
Cancer Treat Res Commun
Year:
2021
Document Type:
Article
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