Abstract
The purpose of this European Society for Radiotherapy and Oncology (ESTRO) project, endorsed by the European Association of Urology, is to explore expert opinion on the management of patients with oligometastatic and oligoprogressive renal cell carcinoma by means of stereotactic ablative radiotherapy (SABR) on extracranial metastases, with the aim of developing consensus recommendations for patient selection, treatment doses, and concurrent systemic therapy. A questionnaire on SABR in oligometastatic renal cell carcinoma was prepared by a core group and reviewed by a panel of ten prominent experts in the field. The Delphi consensus methodology was applied, sending three rounds of questionnaires to clinicians identified as key opinion leaders in the field. At the end of the third round, participants were able to find consensus on eight of the 37 questions. Specifically, panellists agreed to apply no restrictions regarding age (25 [100%) of 25) and primary renal cell carcinoma histology (23 [92%] of 25) for SABR candidates, on the upper threshold of three lesions to offer ablative treatment in patients with oligoprogression, and on the concomitant administration of immune checkpoint inhibitor. SABR was indicated as the treatment modality of choice for renal cell carcinoma bone oligometatasis (20 [80%] of 25) and for adrenal oligometastases 22 (88%). No consensus or major agreement was reached regarding the appropriate schedule, but the majority of the poll (54%–58%) retained the every-other-day schedule as the optimal choice for all the investigated sites. The current ESTRO Delphi consensus might provide useful direction for the application of SABR in oligometastatic renal cell carcinoma and highlight the key areas of ongoing debate, perhaps directing future research efforts to close knowledge gaps.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | The Lancet Oncology |
| Vol/bind | 25 |
| Udgave nummer | 5 |
| Sider (fra-til) | e193-e204 |
| Antal sider | 12 |
| ISSN | 1470-2045 |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:We thank Eralda Azizaj for her valuable contribution to the management of the whole work. The IEO is partially supported by the Italian Ministry of Health (with Ricerca Corrente and 5\u2008\u00D7\u20081000 funds) and by Institutional grants from Accuray. GC and MGV received a research fellowship from the AIRC entitled \u201CRadioablation\u2008\u00B1\u2008hormonotherapy for prostate cancer oligorecurrences (RADIOSA trial): potential of imaging and biology\u201D registered at ClinicalTrials.gov NCT03940235, approved by the Ethics Committee of IEO and Centro Cardiologico Monzino (IEO-997), outside the current study. ACT is supported by a Cancer Research UK Radiation Research Centre of Excellence at The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust (A28724) and a Cancer Research UK Programme Grant (C33589/A28284). ACT and NVA acknowledge National Health Service (NHS) funding to the NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research. SS is supported by the Cancer Council Victoria Colebatch Fellowship. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, or the Department of Health and Social Care. The sponsors had no role in the study design, data collection, data analysis, data interpretation, or writing of the report, or in the decision to submit the manuscript for publication.
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