Table 2.
Radiotherapy characteristics
| Which staging method do you consider necessary to define oligometastasis in PCa (multiple selection possible)? | |
| Choline- or PSMA-PET/CT | 97.0% |
| CT of the thorax and abdomen | 29.9% |
| Bone scan | 29.3% |
| MRI of the abdomen and pelvis | 28.1% |
| Whole-body MRI | 4.8% |
| How is oligometastasis defined in your facility? | |
| 1 metastatic lesion | 1.8% |
| ≤ 2 metastatic lesions | 3.6% |
| ≤ 3 metastatic lesions | 34.1% |
| ≤ 4 metastatic lesions | 4.8% |
| ≤ 5 metastatic lesions | 28.1% |
| If a curative-intent therapy to all lesions is safely possible | 25.7% |
| I do not believe that oligometastasis exists as a separate stage between localized and metastatic disease | 1.2% |
| No answer | 0.6% |
| Which of the following statements best corresponds to your opinion on systemic therapy for OMPC? | |
| Systemic therapy is always recommended for metastatic prostate cancer | 37.1% |
| Radiotherapy should aim to defer systemic therapy | 62.9% |
| Which treatment would you recommend in a fit patient with synchronous oligometastasis and an untreated primary? | |
| Systemic treatment only | 0% |
| PDT only | 1.2% |
| PDT and systemic treatment | 3.0% |
| MDT only | 0.6% |
| MDT and systemic treatment | 2.4% |
| PDT and MDT | 29.3% |
| PDT and MDT and systemic treatment | 63.5% |
| Which fractionation would you choose for PDT? | |
| Normofractionation | 57.5% |
| Hypofractionation | 37.7% |
| SBRT | 4.8% |
| Does the indication for MDT differ in OMPC depending on whether it is distant lymph node metastases or bone metastases? | |
| Yes | 58.7% |
| No | 41.3% |
| Which treatment would you recommend in a fit patient with oligometastatic recurrence with bone metastases? | |
| Systemic treatment only | 1.2% |
| MDT only | 44.9% |
| MDT and systemic treatment | 53.9% |
| Which fractionation do you prefer for MDT for bone metastases? | |
| < 3 fractions | 4.2% |
| 3–5 fractions | 29.9% |
| > 5 fractions | 65.9% |
| Which treatment would you recommend in a fit patient with oligometastatic recurrence with distant lymph node metastases (M1a)? | |
| Systemic therapy only | 1.2% |
| Metastasis-directed radiotherapy (MDT) only | 37.7% |
| MDT + systemic therapy | 60.5% |
| No answer | 0.6% |
| Which fractionation would you prefer for MDT for distant lymph node metastases (M1a)? | |
| Normofractionation | 49.1% |
| Hypofractionation | 26.9% |
| SBRT | 24.0% |
| Which field size would you prefer for MDT for distant lymph node metastases (M1a)? | |
| Focal irradiation of the affected lymph node (involved-node radiotherapy) | 33.5% |
| Irradiation of the affected lymph node region (involved-field radiotherapy) | 22.8% |
| Irradiation of the affected and adjacent lymph node regions (elective nodal radiotherapy) | 29.9% |
| Additional inclusion of the entire pelvic lymphatic drainage area (whole-pelvic radiotherapy) | 13.2% |
| No answer | 0.6% |
| Do you differentiate in the treatment with MDT between synchronous and metachronous oligometastatic disease? | |
| Yes | 43.1% |
| No | 56.3% |
| No answer | 0.6% |
| Which of these factors do you consider relevant for the decision for or against radiotherapy for oligometastatic prostate cancer (multiple selection possible)? | |
| Age | 61.7% |
| Number of metastases | 98.8% |
| Gleason Score | 45.5% |
| Initial PSA | 25.1% |
| PSA before radiotherapy | 38.3% |
| PSA doubling time | 61.1% |
| Hormone sensitivity | 57.5% |
CT computed tomography, MDT metastasis-directed therapy, MRI magnetic resonance imaging, PCa prostate cancer, PDT primary-directed therapy, PSA prostate specific antigen, PSMA-PET/CT prostate specific membrane antigen positron-emission tomography/computed tomography, SBRT stereotactic body radiotherapy