Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy.
Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Milan, Italy.
Med Oncol. 2021 Mar 24;38(5):48. doi: 10.1007/s12032-021-01493-y.
In the last years, several evidences demonstrated the role of stereotactic body radiotherapy (SBRT) in the oligometastatic disease and the possibility to increase survival in selected patients. In 2020 the study group "biology and treatment of the oligometastatic disease" of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) conducted a survey evaluating the attitude of physicians in treating the oligometastatic disease and the definition of it. An electronic questionnaire was administered online to the society members. 105 questionnaires were returned. 78% responders considered as oligometastatic a disease with ≤ 5 metastases. The majority of the responders (77%) treated > 50 patients in the last year, and 89% responders agreed in considering every oligometastatic tumor susceptible to local treatments. Regarding the clinical management of the oligometastatic disease, the majority of the responders (66%) suggested an interdisciplinary discussion. When choosing a treatment option for fit patients with a single oligometastatic focus, 52% of the responders agreed in proposing only SBRT. In the case of unfit patients with a single oligometastatic lesion the agreement was in favor of the SBRT alone (89%). In the oligoprogressive setting, 41% responders opted to continue the current systemic treatment and to add SBRT, while in the case of oligoresidual disease, 70% responders was in favor of adding SBRT and continuing the current systemic treatment. In conclusions, the survey illustrated the current agreement and prescribing attitude for oligometastatic patients in Italy. The non-homogenous agreement in some clinical scenarios suggest the need of more robust evidence.
在过去的几年中，有几项证据表明立体定向体放射治疗（SBRT）在寡转移疾病中的作用，以及在选定的患者中提高生存率的可能性。2020 年，意大利放射治疗和临床肿瘤学协会（AIRO）的“寡转移疾病的生物学和治疗”研究小组进行了一项调查，评估了医生治疗寡转移疾病的态度和对其的定义。向该学会成员在线发放了电子问卷。共收回 105 份问卷。78%的应答者认为寡转移疾病的转移灶数≤5。大多数应答者（77%）在过去一年中治疗了>50 例患者，89%的应答者同意将每一个寡转移肿瘤都视为适合局部治疗的肿瘤。关于寡转移疾病的临床管理，大多数应答者（66%）建议进行跨学科讨论。当为适合治疗且只有一个寡转移灶的患者选择治疗方案时，52%的应答者同意仅推荐 SBRT。对于不适合治疗且只有一个寡转移灶的患者，SBRT 是唯一的治疗选择（89%）。在寡进展的情况下，41%的应答者选择继续当前的全身治疗并加用 SBRT，而在寡残留疾病的情况下，70%的应答者赞成加用 SBRT 并继续当前的全身治疗。总之，该调查说明了意大利目前对寡转移患者的共识和处方态度。在一些临床情况下，意见不一致表明需要更多有力的证据。
