Survey of current practices from an international task force for gynecological stereotactic ablative radiotherapy.

Autor: Leung E; Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada. eric.leung@sunnybrook.ca., Gladwish A; Royal Victoria Hospital, Barrie, ON, Canada., Sahgal A; Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada., Lo SS; Department of Radiation Oncology, University of Washington, Seattle, WA, USA., Kunos CA; National Cancer Institute, Rockville, MD, USA., Lanciano RM; Delaware County Memorial Hospital/Philadelphia Cyberknife, Drexel Hill, PA, USA., Mantz CA; 21st Century Oncology, Fort Myers, FL, USA., Guckenberger M; University Hospital Zuerich, Zuerich, Switzerland., Zagar TM; Northeastern Radiation Oncology, Glen Falls, NY, USA., Mayr NA; Department of Radiation Oncology, University of Washington, Seattle, WA, USA., Chang AR; Soonchunhyang University Seoul Hospital, Seoul, South Korea., Jorcano S; Instituto Oncologico Teknon, Barcelona, Spain., Biswas T; Case Western Reserve University School of Medicine, Cleveland, OH, USA., Pontoriero A; University of Messina, Messina, Italy., Albuquerque KV; University of Texas Southwestern Medical Center, Dallas, TX, USA.
Jazyk: angličtina
Zdroj: Radiation oncology (London, England) [Radiat Oncol] 2020 Jan 30; Vol. 15 (1), pp. 24. Date of Electronic Publication: 2020 Jan 30.
DOI: 10.1186/s13014-020-1469-8
Abstrakt: Background: Stereotactic Ablative Radiotherapy (SABR) is an effective treatment that improves local control for many tumours. However, the role of SABR in gynecological cancers (GYN) has not been well-established. We hypothesize that there exists considerable variation in GYN-SABR practice and technique. The goal of this study is to describe clinical and technical factors in utilization of GYN-SABR among 11 experienced radiation oncologists.
Materials and Methods: A 63 question survey on GYN-SABR was sent to 11 radiation oncologists (5 countries) who have published original research, conducted trials or have an established program at their institutions. Responses were combined and analyzed at a central institution.
Results: Most respondents indicated that salvage therapy (non-irradiated or re-irradiated field) for nodal (81%) and primary recurrent disease (91%) could be considered standard options for SABR in the setting of inability to administer brachytherapy. All other indications should be considered on clinical trials. Most would not offer SABR as a boost in primary treatment off-trial without absolute contraindications to brachytherapy. Multi-modality imaging is often (91%) used for planning including PET, CT contrast and MRI. There is a wide variation for OAR tolerances however small bowel is considered the dose-limiting structure for most experts (91%). Fractionation schedules range from 3 to 6 fractions for nodal/primary definitive and boost SABR.
Conclusions: Although SABR has become increasingly standard in other oncology disease sites, there remains a wide variation in both clinical and technical factors when treating GYN cancers. Nodal and recurrent disease is considered a potential indication for SABR whereas other indications should be offered on clinical trials. This study summarizes SABR practices among GYN radiation oncologists while further studies are needed to establish consensus guidelines for GYN-SABR treatment.
Databáze: MEDLINE
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