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. 2025 Oct 29.
doi: 10.1007/s12094-025-04078-7. Online ahead of print.

Management of high-risk prostate cancer in Spain: results from a national patterns of care survey

Victor Duque-Santana  1   2 , Maria Antonia Gómez-Aparicio  3 , Abrahams Ocanto  4   5 , Elias Gomis Selles  6 , Miren Gaztañaga  7 , Patricia Willisch  8 , Xavier Maldonado Pijoan  9 , Manuel Luis Blanco-Villar  10 , Ivan Henriquez  11 , Pedro Carlos Lara  12 , Ivone Ribeiro  13 , Alai Goñi Ramirez  14 , Marta López Valcárcel  15 , Ignacio Visus Fernández de Manzanos  16 , Susana Pérez Echagüen  17 , Pilar Alonso Martínez  18 , Victoria Vera Barragán  19 , Carmen Velilla Millán  20 , Ana Illescas Vacas  21 , Pilar María Samper Ots  22   23 , Luis Alberto Glaría Enríquez  24 , Angel Montero Luis  25 , Laura Montezuma Niño  26 , Rocío Del Castillo Acuña  27 , Elísabet González Del Portillo  22 , Ferran Ferrer  28   29 , Alfonso Gómez-Iturriaga  30   31 , Antonio José Conde Moreno  32 , Elia Del Cerro Peñalver  33   34 , Felipe Couñago  34   35 , Fernando López-Campos  36 ; URONCOR investigators
Affiliations

Management of high-risk prostate cancer in Spain: results from a national patterns of care survey

Victor Duque-Santana et al. Clin Transl Oncol. .

Abstract

Objective: The management of high-risk (HR) prostate cancer represents a challenge for radiation oncologists. This survey investigates the pattern of care in management of HR-prostate cancer across Spanish institutions.

Materials and methods: We conducted a survey among URONCOR members from March to May 2024. This survey was structured in five sections: diagnosis, radiotherapy, hormonal treatment, follow-up, and future perspectives.

Results: A total of 74 responses from 71 different hospitals were received. Participants have a median professional experienced of 11 years, working most of them (84.9%) in public university hospitals. 97.3% have multidisciplinary tumor board and treat a median of 50 (0-200) HR-prostate cancer patients per year/department. 44.63% of centers use Choline-PET and 28.4% PSMA-PET at diagnosis with 26 different fractionation schedules, the most common is moderate hypofractionation (52.7%): 70 Gy in 28 fractions, followed by 37.5 Gy in 15 fractions + 15 Gy brachytherapy boost (30.4%). 56.8% of the institutions perform whole-pelvic irradiation in N0 patients, with 50.4 Gy in 28 fractions (40.48%) being the most common scheme. 56.8% prescribe an LHRH agonist and 74.6% for 24 months. 75.7% prescribe abiraterone in very high-risk patients. 63.0% use the PHOENIX-criteria to define a recurrence. 38.0% perform PSMA-PET and 39.0% Choline-PET as imaging for recurrence. After local relapse, 73.97% apply a re-irradiation technique with 11 different schedules (32.35%), with HDR-brachytherapy: 13.5 Gy × 2 being the most used (56.16%). 83.8% consider that they achieved good results in HR-prostate cancer.

Conclusion: This study represents the current status of the management of HR-prostate cancer in Spain, highlighting the wide variety of radiotherapy treatments as well as the need for national consensus guidelines.

Keywords: High-risk prostate cancer; Hormonal treatment; PSMA-PET; Radiotherapy; SBRT.

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Conflict of interest statement

Declarations. Conflict of interest: The author declared that they have no conflict of interest. Ethical approval: None. Informed consent: None.

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