Francesco Dionisi1, Alessia Guarneri2, Veronica Dell'Acqua3, Mariacristina Leonardi3, Rita Niespolo4, Gabriella Macchia5, Tiziana Comito6, Maurizio Amichetti7, Pierfrancesco Franco2, Savino Cilla8, Luciana Caravatta9, Filippo Alongi10, Giovanna Mantello11. 1. Proton Therapy Unit, Department of Oncology, Azienda Provinciale per i Servizi Sanitari, APSS, Via al desert, 14, 38123, Trento, Italy. francesco.dionisi@apss.tn.it. 2. Department of Oncology, Radiation Oncology, University of Torino, Turin, Italy. 3. Division of Radiation Oncology, European Institute of Oncology, Milan, Italy. 4. Department of Radiation Oncology, San Gerardo Hospital-University of Milan-Bicocca, Monza, Italy. 5. Radiation Oncology Unit, Research and Care Foundation 'Giovanni Paolo II', Catholic University of Sacred Heart, Campobasso, Italy. 6. Radiation Oncology Department, Humanitas Clinical and Research Center, Italy Cancer Center, Rozzano, Milan, Italy. 7. Proton Therapy Unit, Department of Oncology, Azienda Provinciale per i Servizi Sanitari, APSS, Via al desert, 14, 38123, Trento, Italy. 8. Medical Physics Unit, Research and Care Foundation 'Giovanni Paolo II', Catholic University of Sacred Heart, Campobasso, Italy. 9. Radiation Oncology Department, "San Francesco" Hospital, Nuoro, Italy. 10. Radiation Oncology, Sacro Cuore-Don Calabria Hospital, Negrar-Verona, Italy. 11. Department of Oncology and Radiotherapy, Azienda Ospedaliero Universitaria Ospedali Riuniti, Ancona, Italy.
Abstract
PURPOSE: To report the results of the first Italian survey investigating the role of liver-directed radiotherapy in the multidisciplinary approach of primary and metastatic liver cancer. MATERIALS AND METHODS: A 21-item, two-section questionnaire was sent to all Italian radiotherapy centers on June 2014. The two sections aimed at: (1) evaluating the presence of a multidisciplinary liver tumor board and describing the role of radiation oncologists within the latter, (2) analyzing Radiotherapy treatment details and differences between centers. RESULTS: A total of 37 centers completed the survey. A multidisciplinary liver tumor board was available in most centers (73 %), with a radiation oncologist routinely attending the latter in the majority of cases (85 %). Most of the respondents considered liver-directed Radiotherapy as the third line choice when other therapies were not indicated or technically suitable. 18 centers reported the use of liver-directed radiotherapy. The majority of centers started liver irradiation after 2010. The most adopted motion management strategy was abdominal compression. The most adopted GTV-CTV expansion was 0 and 5 mm for metastases and hepatocellular carcinoma, respectively. Stereotactic body radiotherapy was the technique of choice; several treatment schedules were registered, being 45 Gy in three fractions the most reported fractionation scheme. Dose was prescribed at the PTV margin in most cases. CONCLUSION: Liver-directed radiotherapy represents a new field of interest which is currently adopted by 10 % of all Italian Centers. The technical equipment seems adequate. The variations observed in the treatment regimens reflect the lack of a well-established standard schedule.
PURPOSE: To report the results of the first Italian survey investigating the role of liver-directed radiotherapy in the multidisciplinary approach of primary and metastatic liver cancer. MATERIALS AND METHODS: A 21-item, two-section questionnaire was sent to all Italian radiotherapy centers on June 2014. The two sections aimed at: (1) evaluating the presence of a multidisciplinary liver tumor board and describing the role of radiation oncologists within the latter, (2) analyzing Radiotherapy treatment details and differences between centers. RESULTS: A total of 37 centers completed the survey. A multidisciplinary liver tumor board was available in most centers (73 %), with a radiation oncologist routinely attending the latter in the majority of cases (85 %). Most of the respondents considered liver-directed Radiotherapy as the third line choice when other therapies were not indicated or technically suitable. 18 centers reported the use of liver-directed radiotherapy. The majority of centers started liver irradiation after 2010. The most adopted motion management strategy was abdominal compression. The most adopted GTV-CTV expansion was 0 and 5 mm for metastases and hepatocellular carcinoma, respectively. Stereotactic body radiotherapy was the technique of choice; several treatment schedules were registered, being 45 Gy in three fractions the most reported fractionation scheme. Dose was prescribed at the PTV margin in most cases. CONCLUSION: Liver-directed radiotherapy represents a new field of interest which is currently adopted by 10 % of all Italian Centers. The technical equipment seems adequate. The variations observed in the treatment regimens reflect the lack of a well-established standard schedule.
Authors: Charlie C Pan; Brian D Kavanagh; Laura A Dawson; X Allen Li; Shiva K Das; Moyed Miften; Randall K Ten Haken Journal: Int J Radiat Oncol Biol Phys Date: 2010-03-01 Impact factor: 7.038
Authors: Matthias Guckenberger; Reinhart A Sweeney; Juergen Wilbert; Thomas Krieger; Anne Richter; Kurt Baier; Gerd Mueller; Otto Sauer; Michael Flentje Journal: Int J Radiat Oncol Biol Phys Date: 2008-05-01 Impact factor: 7.038
Authors: Sun Hyun Bae; Mi-Sook Kim; Won Il Jang; Chul-Seung Kay; Woochul Kim; Eun Seog Kim; Jin Ho Kim; Jin Hee Kim; Kwang Mo Yang; Kyu Chan Lee; A Ram Chang; Sunmi Jo Journal: Cancer Res Treat Date: 2014-11-24 Impact factor: 4.679