Stereotactic body radiotherapy for spinal oligometastases: a survey on patterns of practice on behalf of the Italian Association of Clinical Oncology and Radiotherapy (AIRO).

Oligometastases Spine Stereotactic body radiotherapy

Journal

Clinical & experimental metastasis
ISSN: 1573-7276
Titre abrégé: Clin Exp Metastasis
Pays: Netherlands
ID NLM: 8409970

Informations de publication

Date de publication:
01 Aug 2024
Historique:
received: 09 05 2024
accepted: 23 07 2024
medline: 1 8 2024
pubmed: 1 8 2024
entrez: 1 8 2024
Statut: aheadofprint

Résumé

The Study Group for the Biology and Treatment of the OligoMetastatic Disease on behalf of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) has conducted a national survey with the aim to depict the current patterns of practice of stereotactic body radiotherapy (SBRT) for spinal oligometastases. The Surveymonkey platform was used to send a 28-items questionnaire focused on demographic, clinical and technical aspects related to SBRT for spinal oligometastases. All the AIRO members were invited to fill the questionnaire. Data were then centralized to a single center for analysis and interpretation. 53 radiation oncologists from 47 centers fulfilled the survey. A complete agreement was observed in proposing SBRT for spinal oligometastases, with the majority considering up to 3 concurrent spine oligometastases feasible for SBRT (73.5%), regardless of spine site (70%), vertebral segment (85%) and morphological features of the lesion (71.7%). Regarding dose prescription, fractionated regimens resulted as the preferred option, either in 3 (58.4%) or five sessions (34%), with a substantial agreement in applying a PTV-margin larger than 1 mm (almost 90% of participants), and ideally using both MRI and PET imaging to improve target volume and organs-at-risk delineation (67.9%). This national italian survey illustrates the patterns of practice and the main issues for the indication of SBRT for spinal oligometastases. A substantial agreement in the numerical cut-off and vertebral segment involved for SBRT indication was reported, with a slight heterogeneity in terms of dose prescription and fractionation schemes.

Sections du résumé

BACKGROUND BACKGROUND
The Study Group for the Biology and Treatment of the OligoMetastatic Disease on behalf of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) has conducted a national survey with the aim to depict the current patterns of practice of stereotactic body radiotherapy (SBRT) for spinal oligometastases.
METHODS METHODS
The Surveymonkey platform was used to send a 28-items questionnaire focused on demographic, clinical and technical aspects related to SBRT for spinal oligometastases. All the AIRO members were invited to fill the questionnaire. Data were then centralized to a single center for analysis and interpretation.
RESULTS RESULTS
53 radiation oncologists from 47 centers fulfilled the survey. A complete agreement was observed in proposing SBRT for spinal oligometastases, with the majority considering up to 3 concurrent spine oligometastases feasible for SBRT (73.5%), regardless of spine site (70%), vertebral segment (85%) and morphological features of the lesion (71.7%). Regarding dose prescription, fractionated regimens resulted as the preferred option, either in 3 (58.4%) or five sessions (34%), with a substantial agreement in applying a PTV-margin larger than 1 mm (almost 90% of participants), and ideally using both MRI and PET imaging to improve target volume and organs-at-risk delineation (67.9%).
CONCLUSIONS CONCLUSIONS
This national italian survey illustrates the patterns of practice and the main issues for the indication of SBRT for spinal oligometastases. A substantial agreement in the numerical cut-off and vertebral segment involved for SBRT indication was reported, with a slight heterogeneity in terms of dose prescription and fractionation schemes.

Identifiants

DOI: 10.1007/s10585-024-10304-3 PMID: 39088084
pubmed: 39088084
doi: 10.1007/s10585-024-10304-3
pii: 10.1007/s10585-024-10304-3
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Nature B.V.

Références

Ryan C, Stoltzfus KC, Horn S, Chen H, Louie AV, Lehrer EJ et al (2022) Epidemiology of bone metastases. Bone 158:115783. https://doi.org/10.1016/j.bone.2020.115783
doi: 10.1016/j.bone.2020.115783 pubmed: 33276151
Rong Y, Ding X, Daly ME, Hypofractionation (2023 Feb) 25 years of evolution in medical physics and a glimpse of the future. Med Phys 9. https://doi.org/10.1002/mp.16270
Guckenberger M, Lievens Y, Bouma AB, Collette L, Dekker A, deSouza NM et al (2020) Characterisation and classification of oligometastatic disease: a European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus recommendation. Lancet Oncol 21(1):e18–e28. https://doi.org/10.1016/S1470-2045(19)30718-1
doi: 10.1016/S1470-2045(19)30718-1 pubmed: 31908301
Chalkidou A, Macmillan T, Grzeda MT, Peacock J, Summers J, Eddy S, Coker B, Patrick H, Powell H, Berry L, Webster G, Ostler P, Dickinson PD, Hatton MQ, Henry A, Keevil S, Hawkins MA, Slevin N, van As N (2021) Stereotactic ablative body radiotherapy in patients with oligometastatic cancers: a prospective, registry-based, single-arm, observational, evaluation study. Lancet Oncol 22(1):98–106. https://doi.org/10.1016/S1470-2045(20)30537-4
doi: 10.1016/S1470-2045(20)30537-4 pubmed: 33387498
Palma DA, Olson R, Harrow S, Gaede S, Louie AV, Haasbeek C et al (2020) Stereotactic ablative radiotherapy for the Comprehensive Treatment of Oligometastatic Cancers: long-term results of the SABR-COMET phase II randomized trial. J Clin Oncol 38(25):2830–2838. https://doi.org/10.1200/JCO.20.00818
doi: 10.1200/JCO.20.00818 pubmed: 32484754 pmcid: 7460150
Tsai CJ, Yang JT, Shaverdian N, Patel J, Shepherd AF, Eng J, Guttmann D, Yeh R, Gelblum DY, Namakydoust A, Preeshagul I, Modi S, Seidman A, Traina T, Drullinsky P, Flynn J, Zhang Z, Rimner A, Gillespie EF, Gomez DR, Lee NY, Berger M, Robson ME, Reis-Filho JS, Riaz N, Rudin CM, Powell SN, CURB Study Group (2024) Standard-of-care systemic therapy with or without stereotactic body radiotherapy in patients with oligoprogressive breast cancer or non-small-cell lung cancer (consolidative use of Radiotherapy to Block [CURB] oligoprogression): an open-label, randomised, controlled, phase 2 study. Lancet 403(10422):171–182. https://doi.org/10.1016/S0140-6736(23)01857-3
doi: 10.1016/S0140-6736(23)01857-3 pubmed: 38104577
Francolini G, Gaetano Allegra A, Detti B, Di Cataldo V, Caini S, Bruni A, Ingrosso G, D’Angelillo RM, Alitto AR, Augugliaro M, Triggiani L, Parisi S, Facchini G, Banini M, Simontacchi G, Desideri I, Meattini I, Valicenti RK, Livi L, ARTO Working Group members (2023) Stereotactic body Radiation Therapy and Abiraterone acetate for patients affected by Oligometastatic Castrate-resistant prostate Cancer: a Randomized Phase II Trial (ARTO). J Clin Oncol 41(36):5561–5568. https://doi.org/10.1200/JCO.23.00985
doi: 10.1200/JCO.23.00985 pubmed: 37733977
Ouyang W, Yu J, Nuerjiang S, Li Z, Wang D, Wang X, Zhang J, Xie C (2019) Stereotactic body radiotherapy improves the survival of patients with oligometastatic non-small cell lung cancer. Cancer Med 8(10):4605–4614. https://doi.org/10.1002/cam4.2366
doi: 10.1002/cam4.2366 pubmed: 31245933 pmcid: 6712475
Guckenberger M, Mantel F, Sweeney RA, Hawkins M, Belderbos J, Ahmed M et al (2021) Long-term results of dose-intensified fractionated stereotactic body Radiation Therapy (SBRT) for painful spinal metastases. Int J Radiat Oncol Biol Phys 110(2):348–357. https://doi.org/10.1016/j.ijrobp.2020.12.045
doi: 10.1016/j.ijrobp.2020.12.045 pubmed: 33412262
Sprave T, Verma V, Förster R, Schlampp I, Bruckner T, Bostel T et al (2018) Randomized phase II trial evaluating pain response in patients with spinal metastases following stereotactic body radiotherapy versus three-dimensional conformal radiotherapy. Radiother Oncol 128(2):274–282. https://doi.org/10.1016/j.radonc.2018.04.030
doi: 10.1016/j.radonc.2018.04.030 pubmed: 29843899
Sahgal A, Myrehaug SD, Siva S, Masucci GL, Maralani PJ, Brundage M et al (2021) Stereotactic body radiotherapy versus conventional external beam radiotherapy in patients with painful spinal metastases: an open-label, multicentre, randomised, controlled, phase 2/3 trial. Lancet Oncol 22(7):1023–1033. https://doi.org/10.1016/S1470-2045(21)00196-0
doi: 10.1016/S1470-2045(21)00196-0 pubmed: 34126044
Zeng KL, Myrehaug S, Soliman H, Husain ZA, Tseng CL, Detsky J et al Mature local control and reirradiation rates comparing spine stereotactic body radiotherapy to Conventional Palliative External Beam Radiotherapy. Int J Radiat Oncol Biol Phys 2022 Jun 5:S0360–3016(22)00550–8. https://doi.org/10.1016/j.ijrobp.2022.05.043
Diamond IR, Grant RC, Feldman BM, Pencharz PB, Ling SC, Moore AM, Wales PW (2014) Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol 67(4):401–409. https://doi.org/10.1016/j.jclinepi.2013.12.002
doi: 10.1016/j.jclinepi.2013.12.002 pubmed: 24581294
Guckenberger M, Dahele M, Ong WL, Sahgal A (2023) Stereotactic body Radiation Therapy for spinal metastases: benefits and limitations. Semin Radiat Oncol 33(2):159–171. https://doi.org/10.1016/j.semradonc.2022.11.006
doi: 10.1016/j.semradonc.2022.11.006 pubmed: 36990633
Harrow S, Palma DA, Olson R, Gaede S, Louie AV, Haasbeek C et al (2022) Stereotactic Radiation for the Comprehensive Treatment of Oligometastases (SABR-COMET): extended long-term outcomes. Int J Radiat Oncol Biol Phys 114(4):611–616. https://doi.org/10.1016/j.ijrobp.2022.05.004
doi: 10.1016/j.ijrobp.2022.05.004 pubmed: 35643253
McClelland S 3rd, Sun Y, Spratt DE (2023) Spine patient optimal Radiosurgery treatment for symptomatic metastatic neoplasms (SPORTSMEN): a randomized phase II study protocol. Rep Pract Oncol Radiother 28(3):379–388. https://doi.org/10.5603/RPOR.a2023.0037
Guninski RS, Cuccia F, Alongi F, Andratschke N, Belka C, Bellut D, Dahele M, Josipovic M, Kroese TE, Mancosu P, Minniti G, Niyazi M, Ricardi U, Munck Af Rosenschold P, Sahgal A, Tsang Y, Verbakel WFAR, Guckenberger M Efficacy and safety of SBRT for spine metastases: a systematic review and meta-analysis for preparation of an ESTRO practice guideline. Radiother Oncol 2023 Nov 2:109969. https://doi.org/10.1016/j.radonc.2023.109969
Cuccia F, Pastorello E, Franzese C, Belgioia L, Bignardi M, Federico M, Figlia V, Giaj Levra N, Badellino S, Borghetti P, Marvaso G, Montesi G, Pontoriero A, Fazio I, Ferrera G, Alongi F, Scorsetti M (2023) Stereotactic body Radiotherapy for Spine oligometastases: a Multicentre Retrospective Study from the Italian Association of Radiotherapy and Clinical Oncology (AIRO). Clin Oncol (R Coll Radiol) 35(12):794–800. https://doi.org/10.1016/j.clon.2023.09.001
doi: 10.1016/j.clon.2023.09.001 pubmed: 37714793
Guckenberger M, Andratschke N, Belka C, Bellut D, Cuccia F, Dahele M, Guninski RS, Josipovic M, Mancosu P, Minniti G, Niyazi M, Ricardi U, Munck Af Rosenschold P, Sahgal A, Tsang Y, Verbakel W, Alongi F ESTRO clinical practice guideline: stereotactic body radiotherapy for spine metastases. Radiother Oncol 2023 Nov 2:109966. https://doi.org/10.1016/j.radonc.2023.109966
Cox BW, Spratt DE, Lovelock M, Bilsky MH, Lis E, Ryu S, Sheehan J, Gerszten PC, Chang E, Gibbs I, Soltys S, Sahgal A, Deasy J, Flickinger J, Quader M, Mindea S, Yamada Y (2012) International Spine Radiosurgery Consortium consensus guidelines for target volume definition in spinal stereotactic radiosurgery. Int J Radiat Oncol Biol Phys 83(5):e597–605. https://doi.org/10.1016/j.ijrobp.2012.03.009
doi: 10.1016/j.ijrobp.2012.03.009 pubmed: 22608954
Christ SM, Alongi F, Ricardi U, Scorsetti M, Livi L, Balermpas P, Lievens Y, Braam P, Jereczek-Fossa BA, Stellamans K, Ratosa I, Widder J, Peulen H, Dirix P, Bral S, Ramella S, Hemmatazad H, Khanfir K, Geets X, Jeene P, Zilli T, Fournier B, Ivaldi GB, Clementel E, Fortpied C, Oppong FB, Ost P, Guckenberger M (2024) Cancer-specific dose and fractionation schedules in stereotactic body radiotherapy for oligometastatic disease: an interim analysis of the EORTC-ESTRO E2-RADIatE OligoCare study. Radiother Oncol 195:110235. https://doi.org/10.1016/j.radonc.2024.110235
doi: 10.1016/j.radonc.2024.110235 pubmed: 38508239
Zeng KL, Abugarib A, Soliman H, Myrehaug S, Husain ZA, Detsky J, Ruschin M, Karotki A, Atenafu EG, Larouche J, Campbell M, Maralani P, Sahgal A, Tseng CL (2023) Dose-escalated 2-Fraction spine stereotactic body Radiation Therapy: 28 gy Versus 24 gy in 2 daily fractions. Int J Radiat Oncol Biol Phys 115(3):686–695. https://doi.org/10.1016/j.ijrobp.2022.09.076
doi: 10.1016/j.ijrobp.2022.09.076 pubmed: 36309076
Pontoriero A, Iatì G, Cacciola A, Conti A, Brogna A, Siragusa C, Ferini G, Davì V, Tamburella C, Molino L, Cambareri D, Severo C, Parisi S, Settineri N, Ielo I, Pergolizzi S (2020 Jan-Dec) Stereotactic body Radiation Therapy with Simultaneous Integrated Boost in patients with spinal metastases. Technol Cancer Res Treat 19:1533033820904447. https://doi.org/10.1177/1533033820904447
Waltenberger M, Vogel MME, Bernhardt D, Münch S, Dobiasch S, Redmond KJ, Lo SS, Acker G, Fehlings MG, Ringel F, Vajkoczy P, Meyer B, Combs SE (2024) Radiotherapy concepts for spinal metastases-results from an online survey among radiation oncologists of the German Society for Radiation Oncology. Strahlenther Onkol 200(2):159–174. https://doi.org/10.1007/s00066-023-02082-w
doi: 10.1007/s00066-023-02082-w pubmed: 37272996
Pichon B, Rousseau C, Blanc-Lapierre A, Delpon G, Ferrer L, Libois V et al (2020) Targeting stereotactic body radiotherapy on metabolic PET- and Immuno-PET-Positive vertebral metastases. Biomedicines 8(12):548. https://doi.org/10.3390/biomedicines8120548
doi: 10.3390/biomedicines8120548 pubmed: 33260610 pmcid: 7760481
Di Franco R, Pezzulla D, Arcidiacono F, Pontoriero A, Cellini F, Belgioia L, Borzillo V, Lillo S, Pastore F, Dominici L, Longo S, Cacciola A, Ciabattoni A, Zamagni A, Francolini G, Fontana A, Scipilliti E, Mazzola R, D’Angelo E, Ingargiola R, Muto P, Maranzano E (2023) Reirradiation on spine metastases: an Italian survey on behalf of palliative care and reirradiation study groups of Italian association of radiotherapy and clinical oncology (AIRO). Clin Transl Oncol 25(2):408–416. https://doi.org/10.1007/s12094-022-02951-3
doi: 10.1007/s12094-022-02951-3 pubmed: 36163444
Nabors B, Portnow J, Hattangadi-Gluth J, Horbinski C (2023) NCCN CNS tumor guidelines update for 2023. Neuro Oncol 25(12):2114–2116. https://doi.org/10.1093/neuonc/noad169
doi: 10.1093/neuonc/noad169 pubmed: 37706665

Auteurs

Francesco Cuccia (F)

Radiotherapy Unit, ARNAS Civico Hospital, Palermo, 90145, Italy. francesco.cuccia@arnascivico.it.

Ciro Franzese (C)

Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Milan, Italy.

Serena Badellino (S)

Department of Oncology, University of Turin, Turin, Italy.

Paolo Borghetti (P)

Radiation Oncology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy.

Manuela Federico (M)

Radiation Therapy Unit, Clinica Macchiarella, Palermo, Italy.

Giulia Marvaso (G)

Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy.

Giampaolo Montesi (G)

Radiation Oncology Unit, Santa Maria della Misericordia Hospital, Rovigo, Italy.

Antonio Pontoriero (A)

Radiation Oncology Unit, Department of Biomedical, Dental and Morphological and Functional Imaging Sciences, University of Messina, Messina, Italy.

Giuseppe Ferrera (G)

Radiotherapy Unit, ARNAS Civico Hospital, Palermo, 90145, Italy.

Filippo Alongi (F)

Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella (VR), Italy.
University of Brescia, Brescia, Italy.

Marta Scorsetti (M)

Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Milan, Italy.
Department of Biomedical Sciences, Humanitas University, ARNAS Civico Hospital, Milan, Italy.

Classifications MeSH