Protocol AngCN-CCG-RT23

Radiotherapy for Prostate Cancer

Prostate Cancer

Localised disease-early stage Locally advanced (T3b or T4) Node positive or distant
metastasis

Not eligible for radical treatment

LHRH agonist or
Eligible for radical treatment orchidectomy (first line)
Watchful waiting or hormones

Active surveillance Hormones (LHRH agonists)

Options with palliative (55 in 20, 30-36
Suitable for those with
 Radical prostatectomy in 5/6#, 21 in 3) or radical
 T1b/c disease
 Radical radiotherapy with or radiotherapy (64 in 32# )
 Gleason 6 or 7
without hormones 74 Gy in
 PSA density <0.15
37#(IMRT) 64 (PTV1)+10 or
 <50% cores involved
56+18

 PSA progression (doubling time < 2

years)
 Clinical progression High risk features / rising PSA after prostatectomy
 Upgrading of the Gleason score on  Consider postoperative radiotherapy if no metastasis (52.5-55 in 20)
repeat biopsy  Hormones
 Clinical trial
*3-6 months of hormone (LHRH agonists) prior to and concurrent with radiotherapy is considered if:
 pT1b/c
 CT2a-c
 Gleason <8
 PSA≤ 30

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 *3-6 months of hormone (LHRH agonists) prior to and concurrent with radiotherapy is considered if:
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pT1b/c
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CT2a-c
Gleason <8
PSA≤ 30
1 1 MONITORING THE EFFECTIVENESS OF THE PROCESS
a) Process for Monitoring compliance and Effectiveness - Review of compliance as determined by audit. Any non compliance to be presented by QA
Manager to the AngCN Business Meeting on an annual basis – the minutes of this meeting are retained for a minimum of five years.

b) Standards/Key Performance Indicators – This process forms part of a quality system working to, but not accredited to, International Standard BS EN
ISO 9001:2008. The effectiveness of the process will be monitored in accordance with the methods given in the quality manual, AngCN-QM

1.1 Equality and Diversity Statement

This document complies with the Suffolk PCT Equality and Diversity statement – an EIA assessment is available on request to Anglia Cancer Network PQ
Manager, Gibson Centre, Exning Road, Newmarket, CB8 7JG.

1.2 Disclaimer
It is your responsibility to check against the electronic library that this printed out copy is the most recent issue of this document.
Please notify any changes required to the Anglia Cancer Network Quality Assurance Manager

1.3 Document management

Document ratification and history
Approved by: Chair RT Group
Date approved: Date placed on electronic library:
Review period: 2 years (or earlier in the light of new evidence)
Authors: RT Group Document Owner: Anglia Cancer Network, Tel: 01638 608221;
www.angliacancernetwork.nhs.uk
Version number as approved and 1 Unique identifier no.: AngCN-CCG-RT23
published:

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