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寡转移癌的放射治疗:意大利伦巴第(AIRO-Lombardy)放射肿瘤学家的一项调查。

Radiotherapy for oligometastatic cancer: a survey among radiation oncologists of Lombardy (AIRO-Lombardy), Italy.

机构信息

Department of Radiation Oncology, European Institute of Oncology IRCCS, via Ripamonti 435, 20141, Milan, Italy.

Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.

出版信息

Radiol Med. 2019 Apr;124(4):315-322. doi: 10.1007/s11547-018-0972-6. Epub 2018 Dec 15.

Abstract

AIMS

To evaluate the use of radiotherapy (RT) for oligometastatic cancer (OMC) among radiation oncologists in Lombardy, Italy.

METHODS AND STUDY DESIGN

A survey with 12 items regarding data of 2016 was sent to all 34 Lombardy RT centers. The survey included six general items and six specific items regarding patient/disease/treatment characteristics.

RESULTS

Thirteen centers answered the survey (38%). All centers responded to general items and 12 centers submitted patient/disease/treatment data. General items The majority of centers (8/13) consider OMC if metastases number is less than 5. The most commonly prescribed dose/fraction is 5-10 Gy (8/13) using schedules of 3-5 fractions (11/13). Patient data items A total of 15.681 patients were treated in 2016 with external beam RT in 12 responding centers, and 1.087 patients were treated for OMC (7%). Primary tumor included lung, prostate, breast, colorectal and other malignancies in 33%, 21%, 12%, 9% and 25% of all OMC patients, respectively. Brain, lymph node, lung, bone, liver and others were the most common treated sites (24%, 24%, 22%, 17%, 8% and 5%, respectively). One and more than one metastasis were treated in 75 and 25% of patients, respectively. The vast majority of patients (95%) were treated with image-guided intensity-modulated RT or stereotactic RT.

CONCLUSIONS

Seven percent of all RT patients in Lombardy are treated for OMC. Extreme hypofractionation and high-precision RT are commonly employed. The initiative of multicenter and multidisciplinary collaboration has been undertaken in order to prepare the platform for prospective and/or observational studies in OMC.

摘要

目的

评估意大利伦巴第地区放射肿瘤学家对寡转移癌(OMC)的放疗(RT)应用。

方法和研究设计

对所有 34 个伦巴第 RT 中心发送了一项包含 2016 年数据的 12 项调查,包括 6 项一般项目和 6 项关于患者/疾病/治疗特征的具体项目。

结果

13 个中心(38%)回答了调查。所有中心都回答了一般项目,其中 12 个中心提交了患者/疾病/治疗数据。一般项目:大多数中心(8/13)认为转移灶数少于 5 个时为 OMC。最常规定剂量/分割为 5-10Gy(8/13),采用 3-5 次分割(11/13)。患者数据项目:2016 年,12 个有回应的中心共对 15681 名患者进行了外照射 RT 治疗,其中 1087 名患者(7%)接受了 OMC 治疗。所有 OMC 患者中,原发肿瘤分别为肺癌、前列腺癌、乳腺癌、结直肠癌和其他恶性肿瘤,占 33%、21%、12%、9%和 25%。脑、淋巴结、肺、骨、肝和其他部位为最常见的治疗部位(24%、24%、22%、17%、8%和 5%)。75%的患者治疗了 1 个以上转移灶,25%的患者治疗了 1 个转移灶。绝大多数患者(95%)接受了图像引导强度调制 RT 或立体定向 RT 治疗。

结论

伦巴第地区的所有 RT 患者中有 7%接受 OMC 治疗。极端的超分割和高精度 RT 是常用的。已经开展了多中心和多学科合作的倡议,以便为 OMC 的前瞻性和/或观察性研究做好准备。

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