Nägler F, Gleim N, Seiler I, Rühle A, Hering K, Seidel C, Gkika E, Krug D, Blanck O, Moustakis C, Brunner T B, Wittig-Sauerwein A, Nicolay N H
Department of Radiotherapy and Radiation Oncology, University Hospital Leipzig, Stephanstraße 9a, Leipzig, Germany.
Comprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, Germany.
Strahlenther Onkol. 2025 Mar 18. doi: 10.1007/s00066-025-02387-y.
Bone metastases constitute a common indication for both conventional radiotherapy (RT) and stereotactic body radiotherapy (SBRT). Although in recent years guidelines have been proposed for SBRT of spinal and non-spinal metastases, little is known about the use of bone SBRT and the actual patterns of care in German-speaking countries.
We performed an online survey among radiation oncologists (ROs) registered with the interdisciplinary Radiosurgery and Stereotactic Radiotherapy Working Group of the German Society of Radiation Oncology (DEGRO) and the German Society for Medical Physics (DGMP) to collect valuable and robust cross-sectional data on patterns of care for bone SBRT in German-speaking countries.
Of the registered ROs, 35.5% (75/211) completed the online survey. ROs working in high-volume centers irradiating more than 100 patients with bone metastases annually represented the largest group, with 58.7%. Ablative SBRT was mostly performed for bone oligometastases (78.7%). For symptom-directed palliative radiotherapy, the majority of responding physicians (84.3%) still mostly recommend moderately hypofractionated treatment. Nevertheless, 60.9% of participating ROs stated using bone SBRT at least occasionally, also for palliative purposes such as pain control. Our survey also revealed a certain reluctance for the concomitant use of systemic therapies with bone SBRT and heterogeneity regarding target volume definition and dosing for bone SBRT.
Our survey demonstrates that bone SBRT for spinal and non-spinal metastases for oligometastatic disease (OMD) is broadly available in clinical routine care in German-speaking countries. A large heterogeneity regarding indications, dose, and fractionation concepts remains, requiring further efforts for standardization of bone SBRT.
骨转移是传统放疗（RT）和立体定向体部放疗（SBRT）的常见适应证。尽管近年来已针对脊柱和非脊柱转移瘤的SBRT制定了指南，但对于德语国家骨SBRT的使用情况及实际治疗模式知之甚少。
我们对在德国放射肿瘤学会（DEGRO）和德国医学物理学会（DGMP）的跨学科放射外科和立体定向放射治疗工作组注册的放射肿瘤学家（RO）进行了一项在线调查，以收集关于德语国家骨SBRT治疗模式的有价值且可靠的横断面数据。
在注册的RO中，35.5%（75/211）完成了在线调查。每年治疗超过100例骨转移患者的高容量中心的RO占最大比例，为58.7%。消融性SBRT主要用于骨寡转移瘤（78.7%）。对于以症状为导向的姑息性放疗，大多数应答医生（84.3%）仍大多推荐适度低分割治疗。然而，60.9%的参与RO表示至少偶尔使用骨SBRT，也用于疼痛控制等姑息目的。我们的调查还显示，对于骨SBRT与全身治疗联合使用存在一定的抵触情绪，并且在骨SBRT的靶区定义和剂量方面存在异质性。
我们的调查表明，在德语国家的临床常规治疗中，用于寡转移疾病（OMD）的脊柱和非脊柱转移瘤的骨SBRT广泛可用。在适应证、剂量和分割概念方面仍存在很大异质性，需要进一步努力实现骨SBRT的标准化。
