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ESTRO clinical practice guideline : Stereotactic body radiotherapy for spine metastases

Guckenberger, M. ; Andratschke, N. ; Belka, C. ; Bellut, D. ; Cuccia, F. ; Dahele, M. ; Guninski, R. S. ; Josipovic, M. ; Mancosu, P. and Minniti, G. , et al. (2024) In Radiotherapy and Oncology 190.
Abstract

Background and purpose: Recent progress in diagnostics and treatment of metastatic cancer patients have improved survival substantially. These developments also affect local therapies, with treatment aims shifting from short-term palliation to long-term symptom or disease control. There is consequently a need to better define the value of stereotactic body radiotherapy (SBRT) for the treatment of spinal metastases. Methods: This ESTRO clinical practice guideline is based on a systematic literature review conducted according to PRISMA standards, which formed the basis for answering four key questions about the indication and practice of SBRT for spine metastases. Results: The analysis of the key questions based on current evidence... (More)

Background and purpose: Recent progress in diagnostics and treatment of metastatic cancer patients have improved survival substantially. These developments also affect local therapies, with treatment aims shifting from short-term palliation to long-term symptom or disease control. There is consequently a need to better define the value of stereotactic body radiotherapy (SBRT) for the treatment of spinal metastases. Methods: This ESTRO clinical practice guideline is based on a systematic literature review conducted according to PRISMA standards, which formed the basis for answering four key questions about the indication and practice of SBRT for spine metastases. Results: The analysis of the key questions based on current evidence yielded 22 recommendations and 5 statements with varying levels of endorsement, all achieving a consensus among experts of at least 75%. In the majority, the level of evidence supporting the recommendations and statements was moderate or expert opinion, only, indicating that spine SBRT is still an evolving field of clinical research. Recommendations were established concerning the selection of appropriate patients with painful spine metastases and oligometastatic disease. Recommendations about the practice of spinal SBRT covered technical planning aspects including dose and fractionation, patient positioning, immobilization and image-guided SBRT delivery. Finally, recommendations were developed regarding quality assurance protocols, including description of potential SBRT-related toxicity and risk mitigation strategies. Conclusions: This ESTRO clinical practice guideline provides evidence-based recommendations and statements regarding the selection of patients with spinal metastases for SBRT and its safe implementation and practice. Enrollment of patients into well-designed prospective clinical trials addressing clinically relevant questions is considered important.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Clinical practice guideline, SBRT, Spinal metastases
in
Radiotherapy and Oncology
volume
190
article number
109966
publisher
Elsevier
external identifiers
  • pmid:37925107
  • scopus:85177219951
ISSN
0167-8140
DOI
10.1016/j.radonc.2023.109966
language
English
LU publication?
no
additional info
Publisher Copyright: © 2023 The Authors
id
f0d6ff3f-0534-44e6-ba0f-65f05900a9a0
date added to LUP
2024-07-22 13:00:50
date last changed
2024-07-23 02:53:14
@article{f0d6ff3f-0534-44e6-ba0f-65f05900a9a0,
  abstract     = {{<p>Background and purpose: Recent progress in diagnostics and treatment of metastatic cancer patients have improved survival substantially. These developments also affect local therapies, with treatment aims shifting from short-term palliation to long-term symptom or disease control. There is consequently a need to better define the value of stereotactic body radiotherapy (SBRT) for the treatment of spinal metastases. Methods: This ESTRO clinical practice guideline is based on a systematic literature review conducted according to PRISMA standards, which formed the basis for answering four key questions about the indication and practice of SBRT for spine metastases. Results: The analysis of the key questions based on current evidence yielded 22 recommendations and 5 statements with varying levels of endorsement, all achieving a consensus among experts of at least 75%. In the majority, the level of evidence supporting the recommendations and statements was moderate or expert opinion, only, indicating that spine SBRT is still an evolving field of clinical research. Recommendations were established concerning the selection of appropriate patients with painful spine metastases and oligometastatic disease. Recommendations about the practice of spinal SBRT covered technical planning aspects including dose and fractionation, patient positioning, immobilization and image-guided SBRT delivery. Finally, recommendations were developed regarding quality assurance protocols, including description of potential SBRT-related toxicity and risk mitigation strategies. Conclusions: This ESTRO clinical practice guideline provides evidence-based recommendations and statements regarding the selection of patients with spinal metastases for SBRT and its safe implementation and practice. Enrollment of patients into well-designed prospective clinical trials addressing clinically relevant questions is considered important.</p>}},
  author       = {{Guckenberger, M. and Andratschke, N. and Belka, C. and Bellut, D. and Cuccia, F. and Dahele, M. and Guninski, R. S. and Josipovic, M. and Mancosu, P. and Minniti, G. and Niyazi, M. and Ricardi, U. and Munck af Rosenschold, P. and Sahgal, A. and Tsang, Y. and Verbakel, W. F.A.R. and Alongi, F.}},
  issn         = {{0167-8140}},
  keywords     = {{Clinical practice guideline; SBRT; Spinal metastases}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Radiotherapy and Oncology}},
  title        = {{ESTRO clinical practice guideline : Stereotactic body radiotherapy for spine metastases}},
  url          = {{http://dx.doi.org/10.1016/j.radonc.2023.109966}},
  doi          = {{10.1016/j.radonc.2023.109966}},
  volume       = {{190}},
  year         = {{2024}},
}