EORTC-ESTRO OligoCare联盟关于肿瘤转移引导的立体定向体放射治疗与靶向治疗或免疫治疗的系统综述和共识建议。
Metastases-directed stereotactic body radiotherapy in combination with targeted therapy or immunotherapy: systematic review and consensus recommendations by the EORTC-ESTRO OligoCare consortium.
发表日期：2023 Mar
作者：
Stephanie G C Kroeze, Matea Pavic, Karin Stellamans, Yolande Lievens, Carlotta Becherini, Marta Scorsetti, Filippo Alongi, Umberto Ricardi, Barbara Alicja Jereczek-Fossa, Paulien Westhoff, Jasna But-Hadzic, Joachim Widder, Xavier Geets, Samuel Bral, Maarten Lambrecht, Charlotte Billiet, Igor Sirak, Sara Ramella, Ivaldi Giovanni Battista, Sergi Benavente, Almudena Zapatero, Fabiola Romero, Thomas Zilli, Kaouthar Khanfir, Hossein Hemmatazad, Berardino de Bari, Desiree N Klass, Shaukat Adnan, Heike Peulen, Juan Salinas Ramos, Michiel Strijbos, Sanjay Popat, Piet Ost, Matthias Guckenberger
来源：
Best Pract Res Cl Ob
摘要：
对于转移性癌症患者，特别是低肿瘤负荷（即少量转移性疾病）、接受靶向治疗或免疫治疗的患者，立体定向体放射治疗（SBRT）已成为经常实践的治疗策略，并得到指南的支持。尽管在常规临床实践中使用增加了，但有关SBRT与现代靶向治疗或免疫治疗联合使用的安全性的信息很少，缺乏高层次证据指导临床管理。进行系统文献综述以确定SBRT与靶向治疗或免疫治疗联合作用的毒性概况。这些结果为28名欧洲放射治疗和肿瘤学协会（ESTRO）和欧洲研究与治疗癌症组织（EORTC）OligoCare联盟的跨学科专家组成的国际Delphi共识过程提供了依据。共识寻求了针对转移灶定向SBRT与靶向治疗或免疫治疗联合作用的风险缓解策略；围绕SBRT交付时靶向治疗或免疫治疗的中断需求和长度的潜在需求；以及辐射剂量和分数适应的潜在改变。这次系统综述和共识过程的结果，为患有转移性或少量转移性癌症的患者实现安全的转移灶定向SBRT与靶向治疗或免疫治疗的结合提供了最好的证据，旨在指导今天的临床实践和未来临床试验的设计。版权所有© 2023 Elsevier Ltd。保留所有权利。
Stereotactic body radiotherapy (SBRT) for patients with metastatic cancer, especially when characterised by a low tumour burden (ie, oligometastatic disease), receiving targeted therapy or immunotherapy has become a frequently practised and guideline-supported treatment strategy. Despite the increasing use in routine clinical practice, there is little information on the safety of combining SBRT with modern targeted therapy or immunotherapy and a paucity of high-level evidence to guide clinical management. A systematic literature review was performed to identify the toxicity profiles of combined metastases-directed SBRT and targeted therapy or immunotherapy. These results served as the basis for an international Delphi consensus process among 28 interdisciplinary experts who are members of the European Society for Radiotherapy and Oncology (ESTRO) and European Organisation for Research and Treatment of Cancer (EORTC) OligoCare consortium. Consensus was sought about risk mitigation strategies of metastases-directed SBRT combined with targeted therapy or immunotherapy; a potential need for and length of interruption to targeted therapy or immunotherapy around SBRT delivery; and potential adaptations of radiation dose and fractionation. Results of this systematic review and consensus process compile the best available evidence for safe combination of metastases-directed SBRT and targeted therapy or immunotherapy for patients with metastatic or oligometastatic cancer and aim to guide today's clinical practice and the design of future clinical trials.Copyright © 2023 Elsevier Ltd. All rights reserved.