Radiotherapy for oligometastatic cancer: a survey among radiation oncologists of Lombardy (AIRO-Lombardy), Italy
To evaluate the use of radiotherapy (RT) for oligometastatic cancer (OMC) among radiation oncologists in Lombardy, Italy.
Methods and study design
A survey with 12 items regarding data of 2016 was sent to all 34 Lombardy RT centers. The survey included six general items and six specific items regarding patient/disease/treatment characteristics.
Thirteen centers answered the survey (38%). All centers responded to general items and 12 centers submitted patient/disease/treatment data. General items The majority of centers (8/13) consider OMC if metastases number is less than 5. The most commonly prescribed dose/fraction is 5–10 Gy (8/13) using schedules of 3–5 fractions (11/13). Patient data items A total of 15.681 patients were treated in 2016 with external beam RT in 12 responding centers, and 1.087 patients were treated for OMC (7%). Primary tumor included lung, prostate, breast, colorectal and other malignancies in 33%, 21%, 12%, 9% and 25% of all OMC patients, respectively. Brain, lymph node, lung, bone, liver and others were the most common treated sites (24%, 24%, 22%, 17%, 8% and 5%, respectively). One and more than one metastasis were treated in 75 and 25% of patients, respectively. The vast majority of patients (95%) were treated with image-guided intensity-modulated RT or stereotactic RT.
Seven percent of all RT patients in Lombardy are treated for OMC. Extreme hypofractionation and high-precision RT are commonly employed. The initiative of multicenter and multidisciplinary collaboration has been undertaken in order to prepare the platform for prospective and/or observational studies in OMC.
KeywordsOligometastatic cancer Lombardy Radiotherapy Survey Stereotactic body radiotherapy
We thank the AIRO-Lombardia, for the excellent coordination of the activities through the Lombardy centers, and Fondazione IEO-CCM.
Compliance with ethical standards
Conflict of interest
The authors have no disclosure of potential conflicts of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
This is a survey among radiation oncologists. No formal consent is required for this kind of studies.
- 8.Jereczek-Fossa BA, Fanetti G, Fodor C, Ciardo D, Santoro L, Francia CM (2017) Salvage stereotactic body radiotherapy for isolated lymph node recurrent prostate cancer: single institution series of 94 consecutive patients and 124 lymph nodes. Clin Genitourin Cancer 15(4):e623–e632CrossRefGoogle Scholar
- 15.Ricardi U, Badellino S, Filippi AR (2016) Clinical applications of stereotactic radiation therapy for oligometastatic cancer patients: a disease-oriented approach. J Radiat Res 8. pii: rrw006Google Scholar
- 16.Orecchia R, Surgo A, Muto M, Ferrari A, Piperno G, Gerardi MA et al (2016) VERO® radiotherapy for low burden cancer: 789 patients with 957 lesions. Ecancermedicalscience 29(10):677Google Scholar
- 19.Agolli L, Bracci S, Nicosia L, Valeriani M, De Sanctis V, Osti MF (2017) Lung metastases treated with stereotactic ablative radiation therapy in oligometastatic colorectal cancer patients: outcomes and prognostic factors after long-term follow-up. Clin Colorectal Cancer 16(1):58–64CrossRefGoogle Scholar
- 21.Palazzi M et al (2017) Equipment, staffing and provision of Radiotherapy in Lombardy, Italy: results of three sequential “snapshot” surveys performed between 2012 and 2016. Tumori, AIRO, Thousand OaksGoogle Scholar
- 22.www.progettorol.it. Accessed 30 June 2017
- 33.Flickinger JC, Niranjan A (2013) Stereotactic radiosurgery and radiotherapy. In: Halperin EC, Wazer DE, Perez CA, Brady LW (eds) Perez and Brady’s principles and practice of radiation oncology. Lippincott Williams and Wilkins, Philadelphia, pp 351–361Google Scholar
- 37.Alongi F, Arcangeli S, Triggiani L, Mazzola R, Buglione di Monale E, Bastia M, Fersino S et al (2017) On the behalf of Italian Association of Radiation Oncology [AIRO]. Stereotactic ablative radiation therapy in renal cell carcinoma: from oligometastatic to localized disease. Crit Rev Oncol Hematol 117:48–56CrossRefGoogle Scholar
- 42.AJCC–American Joint Committee on Cancer. https://cancerstaging.org/Pages/default.aspx. Accessed 12 Jan 2018
- 44.Gomez DR, Blumenschein GR Jr, Lee JJ, Hernandez M, Ye R, Camidge DR, Doebele RC et al (2016) Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer without progression after first-line systemic therapy: a multicentre, randomised, controlled, phase 2 study. Lancet Oncol 17(12):1672–1682CrossRefGoogle Scholar
- 45.Iyengar P, Wardak Z, Gerber DE, Tumati V, Ahn C, Hughes RS et al (2017) Consolidative radiotherapy for limited metastatic non-small-cell lung cancer: a phase 2 randomized clinical trial. JAMA Oncol. 24:e173501Google Scholar