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Zilli, Thomas; Achard, Verane; Dal Pra, Alan; Schmidt-Hegemann, Nina; Jereczek-Fossa, Barbara Alicja; Lancia, Andrea; Ingrosso, Gianluca; Alongi, Filippo; Aluwini, Shafak; Arcangeli, Stefano; Blanchard, Pierre; Moreno, Antonio Conde; Counago, Felipe; Crehange, Gilles; Dirix, Piet; Iturriaga, Alfonso Gomez; Guckenberger, Matthias; Pasquier, David; Sargos, Paul; Scorsetti, Marta; Supiot, Stephane; Tree, Alison C.; Zapatero, Almudena; Le Guevelou, Jennifer; Ost, Piet and Belka, Claus (2022): Recommendations for radiation therapy in oligometastatic prostate cancer: An ESTRO-ACROP Delphi consensus. In: Radiotherapy and Oncology, Vol. 176: pp. 199-207

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Background and purpose: Oligometastatic prostate cancer is a new and emerging treatment field with only few prospective randomized studies published so far. Despite the lack of strong level I evidence, metastasis-directed therapies (MDT) are widely used in clinical practice, mainly based on retrospective and small phase 2 studies and with a large difference across centers. Pending results of ongoing prospec-tive randomized trials, there is a clear need for more consistent treatment indications and radiotherapy practices.Material and methods: A European Society for Radiotherapy and Oncology (ESTRO) Guidelines Committee consisting of radiation oncologists' experts in prostate cancer was asked to answer a dedicated question-naire, including 41 questions on the main controversial issues with regard to oligometastatic prostate cancer.Results: The panel achieved consensus on patient selection and routine use of prostate-specific mem-brane antigen positron emission tomography (PSMA PET) imaging as preferred staging and restaging imaging. MDT strategies are recommended in the de novo oligometastatic, oligorecurrent and oligopro-gressive disease setting for nodal, bone and visceral metastases. Radiation therapy doses, volumes and techniques were discussed and commented.Conclusion: These recommendations have the purpose of providing standardization and consensus to optimize the radiotherapy treatment of oligometastatic prostate cancer until mature results of random-ized trials are available.(c) 2022 The Author(s). Published by Elsevier B.V. Radiotherapy and Oncology 176 (2022) 199-207 This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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