SEOR SBRT-SG stereotactic body radiation therapy consensus guidelines for non-spine bone metastasis

López-Campos, Fernando; Cacicedo, Jon; Couñago, Felipe; García, Rafael; Leaman-Alcibar, O.; Navarro-Martín, Arturo; Pérez-Montero, Héctor; Conde-Moreno, Antonio J.

doi:10.1007/s12094-021-02695-6

Cited by 13 publications

(6 citation statements)

References 71 publications

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“…On the other side, international guidelines suggested a smaller margin but still the inclusion of a CTV. For example, SEOR guidelines for the treatment of NSBM suggested a 5 mm CTV margin +/−, an extraosseous margin of ≤5 mm in patients with soft tissue cancers, and/or significant disruption of the cortical bone [25]. In another recent guideline, there was no definition of the CTV generation strategy; however, the authors suggested the possibility of giving a low dose to the CTV and a simultaneous boost dose to the GTV [26].…”

Section: Discussionmentioning

confidence: 99%

PSMA-PET/CT-Based Stereotactic Body Radiotherapy (SBRT) in the Treatment of Uncomplicated Non-Spinal Bone Oligometastases from Prostate Cancer

Pastorello

Nicosia

Cuccia

et al. 2023

Cancers

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Background and purpose: Stereotactic body radiotherapy (SBRT) has a consolidated role in the treatment of bone oligometastases from prostate cancer (PCa). While the evidence for spinal oligometastases SBRT was robust, its role in non-spinal-bone metastases (NSBM) is not standardized. In fact, there was no clear consensus about dose and target definition in this setting. The aim of our study was to evaluate efficacy, toxicity, and the pattern of relapse in SBRT delivered to NSBM from PCa. Materials and methods: From 2016 to 2021, we treated a series of oligo-NSBM from PCa with 68Ga-PSMA PET/CT-guided SBRT. The primary endpoint was local progression-free survival (LPFS). The secondary endpoints were toxicity, the pattern of intraosseous relapse, distant progression-free survival (DPFS), polimetastases-free survival (PMFS), and overall survival (OS). Results: a total of 150 NSBM in 95 patients were treated with 30–35 Gy in five fractions. With a median follow-up of 26 months, 1- and 3 years LPFS was 96.3% and 89%, respectively. A biologically effective dose (BED) ≥ 198 Gy was correlated with improved LPFS (p = 0.007). Intraosseous relapse occurred in eight (5.3%) cases. Oligorecurrent disease was associated with a better PMFS compared to de novo oligometastatic disease (p = 0.001) and oligoprogressive patients (p = 0.007). No grade ≥ 3 toxicity occurred. Conclusion: SBRT is a safe and effective tool for NSBM from PCa in the oligometastatic setting. Intraosseous relapse was a relatively rare event. Predictive factors of the improved outcomes were defined.

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Section: Discussionmentioning

confidence: 99%

PSMA-PET/CT-Based Stereotactic Body Radiotherapy (SBRT) in the Treatment of Uncomplicated Non-Spinal Bone Oligometastases from Prostate Cancer

Pastorello

Nicosia

Cuccia

et al. 2023

Cancers

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“…To our knowledge, there are no prospective studies completed to date. The findings of these studies can be seen in Table 3 and Table 4 [ 15 , 30 , 31 , 32 , 33 ]. Additionally, there was a systematic review performed on the topic as well as a survey of radiation oncologists in Japan [ 34 , 35 ].…”

Section: Evidence For Post-operative Radiotherapy In Non-spine Bone M...mentioning

confidence: 99%

“…In the non-operative NSBM setting, 30–35 Gy in 5 fractions has been recommended by some experts [ 15 , 30 , 31 ]. This regimen has been found to be effective in providing local control and symptom relief.…”

Section: Evidence For Post-operative Radiotherapy In Non-spine Bone M...mentioning

confidence: 99%

“…The recent ESTRO ACROP guidelines recommend the use of palliative radiotherapy for uncomplicated bone metastases [ 13 , 14 ]. A taskforce study by Lopez-Campos et al gave some guidance regarding this decision point [ 15 ]. Factors they considered in their decision-making process included CT-based structural rigidity assessment of the bone, percent of body weight involved in limb bearing, circumferential involvement of cortical bone on CT, and the Harrington and Mirels’ scores [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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The Role of Post-Operative Radiotherapy for Non-Spine Bone Metastases (NSBMs)

Ramadan

Arifin

Nguyen

2023

Cancers

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Non-spine bone metastases (NSBMs) can cause significant morbidity and deterioration in the quality of life of cancer patients. This paper reviews the role of post-operative radiotherapy (PORT) in the management of NSBMs and provides suggestions for clinical practice based on the best available evidence. We identified six retrospective studies and several reviews that examined PORT for NSBMs. These studies suggest that PORT reduces local recurrence rates and provides effective pain relief. Based on the literature, PORT was typically delivered as 20 Gy in 5 fractions or 30 Gy in 10 fractions within 5 weeks of surgery. Complete coverage of the surgical hardware is an important consideration when designing an appropriate radiation plan and leads to improved local control. Furthermore, the integration of PORT in a multidisciplinary team with input from radiation oncologists and orthopedic surgeons is beneficial. A multimodal approach including PORT should be considered for an NSBM that requires surgery. However, phase III studies are needed to answer many remaining questions and optimize the management of NSBMs.

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“…It is probable for SBRT not to be useful in patients with generalized metastatic disease, with very large metastases (> 5 cm), or with rapidly progressive disease. 32…”

Section: Non-spine Bone Metastasesmentioning

confidence: 99%

Current uses and applications of stereotactic body radiation therapy

Ramos-Prudencio¹,

Lozano-Ruiz²,

Rodríguez-Laguna³

et al. 2023

GMM

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BackgroundRadiotherapy is an essential component in the treatment of cancer, both in the curative and palliative scenarios. Despite the lack of long-term or phase III studies, its efficacy results for local control are higher than 90%, with similar toxicity to that reported with conventional radiotherapy fractionations. 1 Approximately 60% of patients diagnosed with cancer require it at some point of their treatment. 2 Radiotherapy is estimated to contribute with 40% to the cure of cancer; 3 together with surgery and systemic

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SEOR SBRT-SG stereotactic body radiation therapy consensus guidelines for non-spine bone metastasis

Cited by 13 publications

References 71 publications

PSMA-PET/CT-Based Stereotactic Body Radiotherapy (SBRT) in the Treatment of Uncomplicated Non-Spinal Bone Oligometastases from Prostate Cancer

PSMA-PET/CT-Based Stereotactic Body Radiotherapy (SBRT) in the Treatment of Uncomplicated Non-Spinal Bone Oligometastases from Prostate Cancer

The Role of Post-Operative Radiotherapy for Non-Spine Bone Metastases (NSBMs)

Current uses and applications of stereotactic body radiation therapy

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