The INTER-ROMA Project - a Survey among Italian Radiation Oncologists on Their Approach to the Treatment of Bone Metastases

Author:

,De Bari Berardino1,Chiesa Silvia2,Filippi Andrea Riccardo3,Gambacorta Maria Antonietta2,D'Emilio Valentina4,Murino Paola5,Livi Lorenzo6

Affiliation:

1. Service de Radiothérapie Oncologie, Centre Hospitalier Lyon-Sud, Université Claude Bernard, Pierre Benite cedex, France, and EA 3738

2. Bio-Images and Radiological Sciences Department, Radiotherapy Institute, Catholic University, Rome

3. Department of Medical and Surgical Sciences, Radiation Oncology Unit, University of Turin, Ospedale S. Giovanni Battista, Turin

4. Radiation Oncology Department, Azienda Ospedaliera “Civile-MP Arezzo”, Ragusa

5. Radiation Oncology Department, Ospedale Cardinale Ascalesi, Naples

6. Radiotherapy Unit, University of Florence, Florence, Italy

Abstract

Aims and background Radiotherapy has an established palliative role for bone metastases but despite the large number of patients treated there is still controversy surrounding the optimal radiotherapy schedule to prescribe. The aim of this survey was to determine the decision patterns of Italian radiation oncologists in four different clinical cases of patients with bone metastases. Methods and study design During the latest national meeting of the Italian Association of Radiation Oncology (AIRO), four clinical cases were presented to attending radiation oncologists. The cases were different with respect to the histology of the primary tumor, performance status, pain before and after analgesics, tumor site, and radiological characteristics of the metastatic lesions. For each clinical case the respondents were asked to give an indication for treatment; prescribe doses, volumes and treatment field arrangements; decide whether to prescribe prophylactic supportive therapy or not; and provide information about factors that particularly influenced prescription. Finally, a descriptive statistical analysis was performed. Results Three hundred questionnaires were distributed to radiation oncologists attending the congress. One hundred twenty-five questionnaires were returned but only 122 (40.6%) were adequately completed and considered for the analysis. Considerable differences were observed among radiation oncologists in prescribing and delivering radiotherapy for bone metastases. There was also a notable divergence from international guidelines, which will be discussed in this report. Conclusions Despite the results of clinical trials, Italian radiation oncologists differ considerably in their decisions on treatment doses and volumes. National guidelines are needed in order that patients can be treated uniformly and better data will become available for evidence-based palliative radiotherapy.

Publisher

SAGE Publications

Subject

Cancer Research,Oncology,General Medicine

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