Defining oligometastatic disease from a radiation oncology perspective: An ESTRO-ASTRO consensus document

作者：Yolande Lievens, Matthias Gückenberger, Daniel R. Gomez, Morten Høyer, Puneeth Iyengar, I. Kindts, Alejandra Romero, Daan Nevens, David A. Palma, Catherine Park, Umberto Ricardi, Marta Scorsetti, James B. Yu, Wendy A. Woodward · 发表于：Radiotherapy and Oncology · 年份：2020 · DOI：10.1016/j.radonc.2020.04.003 · 被引用次数：665 · 研究领域：Brain Metastases and Treatment、Management of metastatic bone disease、Lung Cancer Diagnosis and Treatment

BACKGROUND: Recognizing the rapidly increasing interest and evidence in using metastasis-directed radiotherapy (MDRT) for oligometastatic disease (OMD), ESTRO and ASTRO convened a committee to establish consensus regarding definitions of OMD and define gaps in current evidence. METHODS: A systematic literature review focused on curative intent MDRT was performed in Medline, Embase and Cochrane. Subsequent consensus opinion, using a Delphi process, highlighted the current state of evidence and the limitations in the available literature. RESULTS: Available evidence regarding the use of MDRT for OMD mostly derives from retrospective, single-centre series, with significant heterogeneity in patient inclusion criteria, definition of OMD, and outcomes reported. Consensus was reached that OMD is largely independent of primary tumour, metastatic location and the presence or length of a disease-free interval, supporting both synchronous and metachronous OMD. In the absence of clinical data supporting a maximum number of metastases and organs to define OMD, and of validated molecular biomarkers, consensus supported the ability to deliver safe and clinically meaningful radiotherapy with curative intent to all metastatic sites as a minimum requirement for defining OMD in the context of radiotherapy. Systemic therapy induced OMD was identified as a distinct state of OMD. High-resolution imaging to assess and confirm OMD is crucial, including brain imaging when indicated. Minimum common en...