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. 2022 Aug 8:37:33-40.
doi: 10.1016/j.ctro.2022.08.006. eCollection 2022 Nov.

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

F Vilotte  1 , D Pasquier  2 , P Blanchard  3 , S Supiot  4 , J Khalifa  5 , U Schick  6 , T Lacornerie  7 , L Vieillevigne  8 , D Marre  9 , O Chapet  10 , I Latorzeff  11 , N Magne  12 , E Meyer  13 , K Cao  14 , Y Belkacemi  15 , J E Bibault  16 , M Berge-Lefranc  17 , J C Faivre  18 , K Gnep  19 , V Guimas  4 , A Hasbini  20 , J Langrand-Escure  12 , C Hennequin  21 , P Graff  22
Affiliations

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

F Vilotte et al. Clin Transl Radiat Oncol. .

Abstract

Background and purpose: 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.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Metastasis-directed; Non-spine bone metastasis; Oligometastatic; Spine bone metastasis; Stereotactic radiation therapy; Stereotaxy.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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