Recommendations for stereotactic body radiation therapy for spine and non-spine bone metastases. A GETUG (French society of urological radiation oncolgists) consensus using a national two-round modified Delphi survey

• Published in: Clinical and translational radiation oncology Vol. 37; pp. 33 - 40
• Main Authors: Vilotte, F, Pasquier, D, Blanchard, P, Supiot, S, Khalifa, J, Schick, U, Lacornerie, T, Vieillevigne, L, Marre, D, Chapet, O, Latorzeff, I, Magne, N, Meyer, E, Cao, K, Belkacemi, Y, Bibault, J E, Berge-Lefranc, M, Faivre, J C, Gnep, K, Guimas, V, Hasbini, A, Langrand-Escure, J, Hennequin, C, Graff, P
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier 01.11.2022
• Subjects: Metastasis-directed; Oligometastatic; Spine bone metastasis; Non-spine bone metastasis; Stereotaxy; Stereotactic radiation therapy
• ISSN: 2405-6308
• DOI: 10.1016/j.ctro.2022.08.006

The relevance of metastasis-directed stereotactic body radiation therapy (SBRT) remains to be demonstrated through phase III trials. Multiple SBRT procedures have been published potentially resulting in a disparity of practices. Therefore, the french society of urological radiation oncolgists (GETUG) recognized the need for joint expert consensus guidelines for metastasis-directed SBRT in order to standardize practice in trials carried out by the group. After a comprehensive literature review, 97 recommendation statements were created regarding planning and delivery of spine bone (SBM) and non-spine bone metastases (NSBM) SBRT. These statements were then submitted to a national online two-round modified Delphi survey among main GETUG investigators. Consensus was achieved if a statement received ≥ 75 % agreements, a trend to consensus being defined as 65-74 % agreements. Any statement without consensus at round one was re-submitted in round two. Twenty-one out of 29 (72.4%) surveyed experts responded to both rounds. Seventy-five statements achieved consensus at round one leaving 22 statements needing a revote of which 16 achieved consensus and 5 a trend to consensus. The final rate of consensus was 91/97 (93.8%). Statements with no consensus concerned patient selection (3/19), dose and fractionation (1/11), prescription and dose objectives (1/9) and organs at risk delineation (1/15). The voting resulted in the writing of step-by-step consensus guidelines. Consensus guidelines for SBM and NSBM SBRT were agreed upon using a validated modified Delphi approach. These guidelines will be used as per-protocole recommendations in ongoing and further GETUG clinical trials.