1
|
Cuccia F, Franzese C, Badellino S, Borghetti P, Federico M, Marvaso G, Montesi G, Pontoriero A, Ferrera G, Alongi F, Scorsetti M. Stereotactic body radiotherapy for spinal oligometastases: a survey on patterns of practice on behalf of the Italian Association of Clinical Oncology and Radiotherapy (AIRO). Clin Exp Metastasis 2024:10.1007/s10585-024-10304-3. [PMID: 39088084 DOI: 10.1007/s10585-024-10304-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND The Study Group for the Biology and Treatment of the OligoMetastatic Disease on behalf of the Italian Association of Radiotherapy and Clinical Oncology (AIRO) has conducted a national survey with the aim to depict the current patterns of practice of stereotactic body radiotherapy (SBRT) for spinal oligometastases. METHODS The Surveymonkey platform was used to send a 28-items questionnaire focused on demographic, clinical and technical aspects related to SBRT for spinal oligometastases. All the AIRO members were invited to fill the questionnaire. Data were then centralized to a single center for analysis and interpretation. RESULTS 53 radiation oncologists from 47 centers fulfilled the survey. A complete agreement was observed in proposing SBRT for spinal oligometastases, with the majority considering up to 3 concurrent spine oligometastases feasible for SBRT (73.5%), regardless of spine site (70%), vertebral segment (85%) and morphological features of the lesion (71.7%). Regarding dose prescription, fractionated regimens resulted as the preferred option, either in 3 (58.4%) or five sessions (34%), with a substantial agreement in applying a PTV-margin larger than 1 mm (almost 90% of participants), and ideally using both MRI and PET imaging to improve target volume and organs-at-risk delineation (67.9%). CONCLUSIONS This national italian survey illustrates the patterns of practice and the main issues for the indication of SBRT for spinal oligometastases. A substantial agreement in the numerical cut-off and vertebral segment involved for SBRT indication was reported, with a slight heterogeneity in terms of dose prescription and fractionation schemes.
Collapse
Affiliation(s)
- Francesco Cuccia
- Radiotherapy Unit, ARNAS Civico Hospital, Palermo, 90145, Italy.
| | - Ciro Franzese
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Milan, Italy
| | | | - Paolo Borghetti
- Radiation Oncology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | | | - Giulia Marvaso
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Giampaolo Montesi
- Radiation Oncology Unit, Santa Maria della Misericordia Hospital, Rovigo, Italy
| | - Antonio Pontoriero
- Radiation Oncology Unit, Department of Biomedical, Dental and Morphological and Functional Imaging Sciences, University of Messina, Messina, Italy
| | | | - Filippo Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella (VR), Italy
- University of Brescia, Brescia, Italy
| | - Marta Scorsetti
- Radiotherapy and Radiosurgery Department, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, ARNAS Civico Hospital, Milan, Italy
| |
Collapse
|
2
|
Ah-Thiane L, Rousseau C, Supiot S. In Regard to Trotter et al. Adv Radiat Oncol 2024; 9:101410. [PMID: 38405301 PMCID: PMC10885587 DOI: 10.1016/j.adro.2023.101410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 08/30/2023] [Indexed: 02/27/2024] Open
Affiliation(s)
- Loic Ah-Thiane
- Department of Radiotherapy, ICO René Gauducheau, Boulevard Jacques Monod, St-Herblain, France
| | - Caroline Rousseau
- Department of Nuclear Medicine, ICO René Gauducheau, St. Herblain, France
- CRCIbNA, UMR ac07 Inserm—UMR 6075 CNRS, Nantes University, Nantes, France
| | - Stéphane Supiot
- Department of Radiotherapy, ICO René Gauducheau, Boulevard Jacques Monod, St. Herblain, France
- CRCI2NA, Inserm UMR1232, CNRS ERL 6001, Nantes University, Nantes, France
| |
Collapse
|
3
|
Cuccia F, Pastorello E, Franzese C, Belgioia L, Bignardi M, Federico M, Figlia V, Giaj Levra N, Badellino S, Borghetti P, Marvaso G, Montesi G, Pontoriero A, Fazio I, Ferrera G, Alongi F, Scorsetti M. Stereotactic Body Radiotherapy for Spine Oligometastases: A Multicentre Retrospective Study From the Italian Association of Radiotherapy and Clinical Oncology (AIRO). Clin Oncol (R Coll Radiol) 2023; 35:794-800. [PMID: 37714793 DOI: 10.1016/j.clon.2023.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/26/2023] [Accepted: 09/04/2023] [Indexed: 09/17/2023]
Abstract
AIM To evaluate the efficacy of stereotactic body radiotherapy (SBRT) for spine oligometastases. MATERIALS AND METHODS This was a multicentre retrospective study of a series of patients who received SBRT for spine oligometastases. The efficacy of SBRT was evaluated in terms of local control as the primary endpoint. Survival outcomes were also analysed to identify predictive factors for clinical outcomes. Toxicity was assessed according to CTCAE v4.0. RESULTS Between March 2018 and July 2022, 183 lesions in 177 patients were analysed. In most patients, SBRT was delivered to a single spine metastasis (82%) for a median total dose of 21 Gy (14-35 Gy) in three fractions (one to five fractions) and a median BED10 = 119 Gy (57.7-152 Gy). Local control rates were 90.3% at 1 year, 84.3% at 2 years and 84.3% at 3 years. Distant progression-free survival rates were 33.1%, 18.5% and 12.4% at 1, 2 and 3 years, with prostate histology (P = 0.023), oligorecurrent disease (P = 0.04) and BED10 > 100 Gy (P = 0.04) found to be predictive on univariate analysis. A further oligometastatic progression was observed in 33 patients (18.6%) treated with a second course of SBRT, reporting at univariate analysis improved overall survival rates (P = 0.01). Polymetastases-free survival rates were 57.8%, 43.4% and 32.4%; concurrent therapy was related to improved outcomes at multivariate analysis (P = 0.009). Overall survival rates were 91.8%, 79.6% and 65.9%, with prostate histology and non-cervical metastases related to better overall survival at multivariate analysis. Pain-flare after SBRT was recorded in 3.3%; five patients underwent surgical decompression after SBRT; there were no grade ≥3 adverse events. CONCLUSIONS In our experience of only oligometastatic patients, spine SBRT gave excellent results in terms of safety and efficacy. Prostate histology and oligorecurrent disease were predictive factors for improved clinical outcomes; also, patients who experienced a further oligoprogression after SBRT maintained a survival advantage compared with polymetastatic progression. No severe adverse events were reported.
Collapse
Affiliation(s)
- F Cuccia
- Radiotherapy Unit, ARNAS Civico Hospital, Palermo, Italy.
| | - E Pastorello
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella (VR), Italy
| | - C Franzese
- IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, Milan, Italy
| | - L Belgioia
- Radiation Oncology Department, San Martino Teaching Hospital, Genova University (DISSAL), Genoa, Italy
| | - M Bignardi
- Radiation Oncology Center, Fondazione Poliambulanza, Brescia, Italy
| | - M Federico
- Radiation Therapy Unit, Clinica Macchiarella, Palermo, Italy
| | - V Figlia
- Radiotherapy Unit, ARNAS Civico Hospital, Palermo, Italy
| | - N Giaj Levra
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella (VR), Italy
| | - S Badellino
- Department of Oncology, University of Turin, Turin, Italy
| | - P Borghetti
- Radiation Oncology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - G Marvaso
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - G Montesi
- Radiation Oncology Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
| | - A Pontoriero
- Radiation Oncology Unit, Department of Biomedical, Dental and Morphological and Functional Imaging Sciences, University of Messina, Messina, Italy
| | - I Fazio
- Radiation Therapy Unit, Clinica Macchiarella, Palermo, Italy
| | - G Ferrera
- Radiotherapy Unit, ARNAS Civico Hospital, Palermo, Italy
| | - F Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella (VR), Italy; University of Brescia, Brescia, Italy
| | - M Scorsetti
- IRCCS Humanitas Research Hospital, Radiotherapy and Radiosurgery Department, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| |
Collapse
|
4
|
O'Brien SR, Ward R, Wu GG, Bagheri S, Kiani M, Challa A, Ulaner GA, Pantel AR, McDonald ES. Other Novel PET Radiotracers for Breast Cancer. PET Clin 2023; 18:557-566. [PMID: 37369615 DOI: 10.1016/j.cpet.2023.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Many novel PET radiotracers have demonstrated potential use in breast cancer. Although not currently approved for clinical use in the breast cancer population, these innovative imaging agents may one day play a role in the diagnosis, staging, management, and even treatment of breast cancer.
Collapse
Affiliation(s)
- Sophia R O'Brien
- Department of Radiology, Hospital of the University of Pennsylvania, 1 Donner, 3400 Spruce Street, Philadelphia, PA 19104, USA.
| | - Rebecca Ward
- Department of Radiology, Hospital of the University of Pennsylvania, 1 Donner, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Grace G Wu
- Department of Radiology, Hospital of the University of Pennsylvania, 1 Donner, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Sina Bagheri
- Department of Radiology, Hospital of the University of Pennsylvania, 1 Donner, 3400 Spruce Street, Philadelphia, PA 19104, USA. https://twitter.com/Sina_Bagherii
| | - Mahsa Kiani
- Department of Radiology, Hospital of the University of Pennsylvania, 1 Donner, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Ashrit Challa
- Department of Radiology, Hospital of the University of Pennsylvania, 1 Donner, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Gary A Ulaner
- Molecular Imaging and Therapy, Hoag Family Cancer Institute, Irvine, CA 92618, USA; Radiology and Translational Genomics, University of Southern California, Los Angeles, CA 90033, USA
| | - Austin R Pantel
- Department of Radiology, Hospital of the University of Pennsylvania, 1 Donner, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Elizabeth S McDonald
- Department of Radiology, Hospital of the University of Pennsylvania, 1 Donner, 3400 Spruce Street, Philadelphia, PA 19104, USA.
| |
Collapse
|
5
|
Vaz SC, Graff SL, Ferreira AR, Debiasi M, de Geus-Oei LF. PET/CT in Patients with Breast Cancer Treated with Immunotherapy. Cancers (Basel) 2023; 15:cancers15092620. [PMID: 37174086 PMCID: PMC10177398 DOI: 10.3390/cancers15092620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023] Open
Abstract
Significant advances in breast cancer (BC) treatment have been made in the last decade, including the use of immunotherapy and, in particular, immune checkpoint inhibitors that have been shown to improve the survival of patients with triple negative BC. This narrative review summarizes the studies supporting the use of immunotherapy in BC. Furthermore, the usefulness of 2-deoxy-2-[18F]fluoro-D-glucose (2-[18F]FDG) positron emission/computerized tomography (PET/CT) to image the tumor heterogeneity and to assess treatment response is explored, including the different criteria to interpret 2-[18F]FDG PET/CT imaging. The concept of immuno-PET is also described, by explaining the advantages of mapping treatment targets with a non-invasive and whole-body tool. Several radiopharmaceuticals in the preclinical phase are referred too, and, considering their promising results, translation to human studies is needed to support their use in clinical practice. Overall, this is an evolving field in BC treatment, despite PET imaging developments, the future trends also include expanding immunotherapy to early-stage BC and using other biomarkers.
Collapse
Affiliation(s)
- Sofia C Vaz
- Nuclear Medicine-Radiopharmacology, Champalimaud Center for the Unkown, Champalimaud Foundation, 1400-038 Lisbon, Portugal
- Department of Radiology, Leiden University Medical Center, P.O. Box 9600-2300 RC Leiden, The Netherlands
| | - Stephanie L Graff
- Division of Hematology/Oncology, Lifespan Cancer Institute, Providence, RI 02903, USA
- Legorreta Cancer Center, The Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
| | - Arlindo R Ferreira
- Católica Medical School, Universidade Católica Portuguesa, 2635-631 Lisbon, Portugal
| | - Márcio Debiasi
- Breast Cancer Unit, Champalimaud Center for the Unkown, Champalimaud Foundation, 1400-038 Lisbon, Portugal
| | - Lioe-Fee de Geus-Oei
- Department of Radiology, Leiden University Medical Center, P.O. Box 9600-2300 RC Leiden, The Netherlands
- Biomedical Photonic Imaging Group, University of Twente, P.O. Box 217-7500 AE Enschede, The Netherlands
- Department of radiation Science & Technology, Delft University of Technology, P.O. Postbus 5 2600 AA Delft, The Netherlands
| |
Collapse
|
6
|
Yeh ES. Special Issue: Cancer Metastasis and Therapeutic Resistance. Biomedicines 2023; 11:biomedicines11051347. [PMID: 37239018 DOI: 10.3390/biomedicines11051347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Metastasis and resistance to cancer therapeutics are critical barriers to curing cancer. This special issue entitled "Cancer Metastasis and Therapeutic Resistance" contains nine original contributions. The articles span a variety of human cancers, including breast, lung, brain, prostate, and skin and touch upon significant areas of interest such as cancer stem cell function, cancer immunology, and glycosylation.
Collapse
Affiliation(s)
- Elizabeth S Yeh
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Melvin and Bren Simon Comprehensive Cancer Center, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| |
Collapse
|
7
|
Manafi-Farid R, Ataeinia B, Ranjbar S, Jamshidi Araghi Z, Moradi MM, Pirich C, Beheshti M. ImmunoPET: Antibody-Based PET Imaging in Solid Tumors. Front Med (Lausanne) 2022; 9:916693. [PMID: 35836956 PMCID: PMC9273828 DOI: 10.3389/fmed.2022.916693] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/24/2022] [Indexed: 12/13/2022] Open
Abstract
Immuno-positron emission tomography (immunoPET) is a molecular imaging modality combining the high sensitivity of PET with the specific targeting ability of monoclonal antibodies. Various radioimmunotracers have been successfully developed to target a broad spectrum of molecules expressed by malignant cells or tumor microenvironments. Only a few are translated into clinical studies and barely into clinical practices. Some drawbacks include slow radioimmunotracer kinetics, high physiologic uptake in lymphoid organs, and heterogeneous activity in tumoral lesions. Measures are taken to overcome the disadvantages, and new tracers are being developed. In this review, we aim to mention the fundamental components of immunoPET imaging, explore the groundbreaking success achieved using this new technique, and review different radioimmunotracers employed in various solid tumors to elaborate on this relatively new imaging modality.
Collapse
Affiliation(s)
- Reyhaneh Manafi-Farid
- Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahar Ataeinia
- Department of Radiology, Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Shaghayegh Ranjbar
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Zahra Jamshidi Araghi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mobin Moradi
- Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Christian Pirich
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Mohsen Beheshti
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- *Correspondence: Mohsen Beheshti ; orcid.org/0000-0003-3918-3812
| |
Collapse
|
8
|
Thureau S, Supiot S, Jouglar E, Rogé M, Lebret L, Hadj Henni A, Beldjoudi G, Lagrange JL, Faivre JC. Radiotherapy of bone metastases. Cancer Radiother 2021; 26:368-376. [PMID: 34955420 DOI: 10.1016/j.canrad.2021.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We present the update of the recommendations of the French society of oncological radiotherapy on bone metastases. This is a common treatment in the management of patients with cancer. It is a relatively simple treatment with proven efficacy in reducing pain or managing spinal cord compression. More complex treatments by stereotaxis can be proposed for oligometastatic patients or in case of reirradiation. In this context, increased vigilance should be given to the risks to the spinal cord.
Collapse
Affiliation(s)
- S Thureau
- Département de radiothérapie et de physique médicale, Quantif-Litis EA 4108, centre Henri-Becquerel, 76038 Rouen, France.
| | - S Supiot
- Service de radiothérapie, Institut de cancérologie de l'Ouest centre René- Gauducheau, 44800 Saint-Herblain, France
| | - E Jouglar
- Service de radiothérapie, Institut de cancérologie de l'Ouest centre René- Gauducheau, 44800 Saint-Herblain, France
| | - M Rogé
- Département de radiothérapie et de physique médicale, Quantif-Litis EA 4108, centre Henri-Becquerel, 76038 Rouen, France
| | - L Lebret
- Département de radiothérapie et de physique médicale, Quantif-Litis EA 4108, centre Henri-Becquerel, 76038 Rouen, France
| | - A Hadj Henni
- Département de radiothérapie et de physique médicale, Quantif-Litis EA 4108, centre Henri-Becquerel, 76038 Rouen, France
| | - G Beldjoudi
- Département de radiothérapie, centre Léon-Bérard, 69000 Lyon, France
| | | | - J-C Faivre
- Département de radiothérapie, Institut de cancérologie de Lorraine centre Alexis-Vautrin, 54519 Vandœuvre-lès-Nancy, France
| |
Collapse
|
9
|
Thureau S, Rogé M, Marchesi V, Hadj Henni A, Faivre JC. [Stereotactic body radiation therapy for spine bone oligometastatic disease]. Cancer Radiother 2021; 25:830-836. [PMID: 34716092 DOI: 10.1016/j.canrad.2021.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/19/2021] [Accepted: 08/22/2021] [Indexed: 10/20/2022]
Abstract
Stereotactic radiotherapy is an ever more common technique, regardless of the location treated. However, spinal stereotactic radiotherapy requires a particular technicality in order to ensure its proper realization. There is now a large literature defining the type of imaging to be used, the dose to be delivered and the delineation of target volumes. This technique can achieve a significant local control and an interesting analgesic efficiency. However, its place in relation to conventional radiotherapy remains limited because it requires MRI imaging and a significantly longer patient management during the treatment fraction. In this context, it is currently mainly restricted to oligometastatic patients or for re-irradiations.
Collapse
Affiliation(s)
- S Thureau
- Département de radiothérapie et de physique médicale, centre Henri-Becquerel-CLCC-Unicancer, Quantif-Litis EA 4108, rue d'Amiens, 76038 Rouen, France.
| | - M Rogé
- Département de radiothérapie et de physique médicale, centre Henri-Becquerel-CLCC-Unicancer, Quantif-Litis EA 4108, rue d'Amiens, 76038 Rouen, France
| | - V Marchesi
- Lorraine Institute of Cancerology-Alexis-Vautrin Comprehensive Cancer Center, Academic Radiation Oncology & Brachytherapy Department, 6, avenue de Bourgogne, Vandoeuvre Lès Nancy 4519, France
| | - A Hadj Henni
- Département de radiothérapie et de physique médicale, centre Henri-Becquerel-CLCC-Unicancer, Quantif-Litis EA 4108, rue d'Amiens, 76038 Rouen, France
| | - J C Faivre
- Lorraine Institute of Cancerology-Alexis-Vautrin Comprehensive Cancer Center, Academic Radiation Oncology & Brachytherapy Department, 6, avenue de Bourgogne, Vandoeuvre Lès Nancy 4519, France
| |
Collapse
|