Practice Patterns of Reirradiation for Brain and Spinal Tumors-An International Survey From the Reirradiation Collaborative Group (ReCOG).

IF 3.5 3区医学 Q2 ONCOLOGY

Practical Radiation Oncology Pub Date : 2025-04-23 DOI:10.1016/j.prro.2025.04.003

Xuguang Scott Chen, Lei Zhang, Thankamma Ajithkumar, Anish A Butala, Michelle M Kim, Charles Mayo, Benjamin S Rosen, Colette J Shen, Louise Murray

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引用次数: 0

Abstract

Purpose: An international workshop was convened by the Reirradiation Collaborative Group. We conducted a survey among the invited attendants to assess practice patterns of reirradiation for central nervous system tumors.

Methods and materials: A web-based survey regarding central nervous system reirradiation was distributed to an international group of radiation oncologists and medical physicists via email.

Results: Sixty-six respondents from 20 countries completed at least one section of the survey. The most important clinical considerations were treatment goal, degree of overlap, and cumulative dose. Among technical challenges, uncertainties in tolerance of organs at risk (OARs), tissue recovery factors (TRFs) and dose accumulation ranked the highest. Most respondents (68%) used a planning OAR volume with 0 to 3 mm margin. Highly conformal radiation techniques were preferred, including stereotactic body radiation therapy for spine (85%), intensity modulated radiation therapy for adult primary brain tumors (93%), and intensity modulated radiation therapy (100%) and proton therapy (83%) for pediatric cases. Most performed dose accumulation (65%) and evaluated cumulative biological (ie, equieffective) dose (88%). Sixty-one percent preferred rigid registration, whereas 35% used deformable registration, most commonly in pediatric cases (67%). The most frequently used α/β value for OARs was 2 Gy (76%). There was no clear consensus on OAR tolerance for any disease site. Different dose metrics were used for evaluation, including Dmax (48%) and D0.1cc (48%). Most (79%) considered time intervals between radiation courses. For adult primary brain tumors and brain metastasis, 50% and 46% recommended against reirradiation within a short interval (3-6 months). Most respondents (52%) used time dependent TRFs.

Conclusions: Among respondents, there are substantial variations in approaches to reirradiation (eg, addition of systemic therapy) and uncertainties in technical implementation (eg, OAR tolerance, TRF, and dose accumulation). Future collaborative registry-based and prospective studies should help address these uncertainties.

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脑和脊柱肿瘤再照射的实践模式——再照射协作组（ReCOG）的一项国际调查。

目的：再照射协作组（ReCOG）召集了一次国际研讨会。我们在受邀的与会者中进行了一项调查，以评估中枢神经系统（CNS）肿瘤再照射的实践模式。方法和材料：通过电子邮件向国际放射肿瘤学家和医学物理学家小组分发了一份关于中枢神经系统再照射的网络调查。结果：来自20个国家的66名受访者至少完成了调查的一个部分。最重要的临床考虑因素是治疗目标、重叠程度和累积剂量。在技术挑战中，风险器官耐受性（OAR）、组织恢复因子（TRF）和剂量累积的不确定性排名最高。大多数受访者（68%）使用0- 3mm余量的规划桨体积（PRV）。高度适形放疗技术是首选，包括脊柱立体定向放疗（85%），成人原发性脑肿瘤调强放疗（IMRT）（93%），儿童病例IMRT（100%）和质子治疗（83%）。大多数进行剂量累积（65%）和评估累积生物（即等有效）剂量（88%）。61%的人喜欢刚性注册，而35%的人使用可变形注册，最常见于儿科病例（67%）。最常用的α/β值为2Gy（76%）。对于任何疾病部位的OAR耐受性没有明确的共识。使用不同的剂量指标进行评估，包括Dmax（48%）和D0.1cc（48%）。大多数（79%）考虑两次放射治疗之间的时间间隔。对于成人原发性脑肿瘤和脑转移，50%和46%的人建议在短时间间隔（3-6个月）内不进行再照射。大多数受访者（52%）使用时间依赖的trf。结论：在应答者中，再照射的方法存在很大差异（如增加全身治疗），技术实施存在不确定性（如OAR耐受性、TRF、剂量累积）。未来基于注册表的合作研究和前瞻性研究应该有助于解决这些不确定性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Practical Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

6.10%

发文量

177

审稿时长

34 days

期刊介绍： The overarching mission of Practical Radiation Oncology is to improve the quality of radiation oncology practice. PRO''s purpose is to document the state of current practice, providing background for those in training and continuing education for practitioners, through discussion and illustration of new techniques, evaluation of current practices, and publication of case reports. PRO strives to provide its readers content that emphasizes knowledge "with a purpose." The content of PRO includes: Original articles focusing on patient safety, quality measurement, or quality improvement initiatives Original articles focusing on imaging, contouring, target delineation, simulation, treatment planning, immobilization, organ motion, and other practical issues ASTRO guidelines, position papers, and consensus statements Essays that highlight enriching personal experiences in caring for cancer patients and their families.