Macchia Gabriella, Pezzulla Donato, Russo Donatella, Campitelli Maura, Lucci Simona, Fanelli Mara, Deodato Francesco, Fagotti Anna, Gambacorta Maria Antonietta, Savarese Antonella, Pignata Sandro, Aristei Cynthia, Ferrandina Gabriella
Radiation Oncology Unit, Laboratories and Services Department, Responsible Research Hospital, Campobasso.
Radiotherapy Unit, Radiotherapy Department, Ospedale 'Vito Fazzi', Lecce.
Anticancer Drugs. 2025 Mar 1;36(3):238-245. doi: 10.1097/CAD.0000000000001684. Epub 2025 Jan 8.
The aim of this study was to present a nationwide survey on the specialist's attitudes towards stereotactic body radiotherapy (SBRT) combined with poly (ADP-ribose) polymerase inhibitors (PARPi) with oligometastatic/oligoprogressive/oligorecurrent ovarian cancer (oMPR-OC) patients. The 19-item questionnaire was developed by specialists and distributed online. Replies were stratified by categories and analyzed using descriptive statistics. Respondents ( N = 100) were radiation oncologists (57%), medical oncologists (32%), and gynecologic oncologists (11%). Fifty-four percent of respondents considered medical oncologists as the primary oncologists for oMPR-OC, while 23% preferred radiation oncologists and 15% favored gynecologic oncologists. Seventy-three percent discuss these cases in the Multidisciplinary Tumor Board, while 15, 6, and 2% send the patients straight to SBRT, surgery, or chemotherapy, respectively. Seventy-four percent of the experts interviewed were treated with SBRT less than 10 oMPR-OC patients. Concomitant treatment was highly heterogeneous, but it had little to no reported side effects. A significant variation in how PARPi is managed during SBRT was found: 34% do not interrupt the administration, while 52% pause and restart it later. Forty-three percent of respondents believe that the PARPi dosage should not be reduced when administered concurrently with SBRT. Sixty-nine percent of respondents believe that the SBRT dose should not be decreased while receiving PARPi if the constraints are met. The majority of respondents (40%) favored expert consensus for enhancing the clinical management of oMPR-OC, while 34% preferred clinical guidelines. A lack of or low toxicity with the combination of PARPi and SBRT was perceived, and a significant degree of heterogeneity concerning clinical protocols for their combination. Moreover, it emphasizes the low number of patients who have received this treatment approach nationwide.
本研究的目的是针对专科医生对立体定向体部放疗（SBRT）联合聚（ADP - 核糖）聚合酶抑制剂（PARPi）治疗寡转移/寡进展/寡复发性卵巢癌（oMPR - OC）患者的态度开展一项全国性调查。这份包含19个条目的问卷由专科医生编制并在线发放。回复按类别分层，并采用描述性统计方法进行分析。受访者（N = 100）包括放射肿瘤学家（57%）、医学肿瘤学家（32%）和妇科肿瘤学家（11%）。54%的受访者认为医学肿瘤学家是oMPR - OC的主要肿瘤专科医生，而23%倾向于放射肿瘤学家，15%支持妇科肿瘤学家。73%的受访者会在多学科肿瘤委员会中讨论这些病例，而分别有15%、6%和2%的受访者会直接将患者送去接受SBRT、手术或化疗。74%接受访谈的专家治疗过的接受SBRT的oMPR - OC患者少于10例。同步治疗方式高度异质性，但几乎没有报告的副作用。研究发现，在SBRT期间PARPi的管理方式存在显著差异：34%的人不中断给药，而52%的人会暂停并随后重新开始给药。43%的受访者认为在与SBRT同时给药时PARPi剂量不应降低。69%的受访者认为如果满足限制条件，在接受PARPi治疗时SBRT剂量不应降低。大多数受访者（40%）赞成通过专家共识来加强oMPR - OC的临床管理，而34%的人更喜欢临床指南。人们认为PARPi与SBRT联合使用时毒性缺乏或较低，并且它们联合使用的临床方案存在显著异质性。此外，它强调了在全国范围内接受这种治疗方法的患者数量较少。
