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.

Advanced Radiation Oncology department IRCCS Sacro Cuore don Calabria Hospital Negrar di Valpolicella Italy; Department of Radiation Oncology University of Brescia Brescia Italy

Department of Oncology Aberdeen Royal Infirmary UK

Department of Oncology and Radiotherapy University Hospital Hradec Králové Czech Republic

Department of Oncology GasthuisZusters Antwerpen Antwerpen Belgium

Department of Oncology University of Turin Turin Italy

Department of Radiation Oncology AZ Groeninge Campus Kennedylaan Kortrijk Belgium

Department of Radiation Oncology Campus Bio Medico University of Rome Rome Italy

Department of Radiation Oncology Careggi University Hospital Florence Italy

Department of Radiation Oncology Catharina Hospital Eindhoven Netherlands

Department of Radiation Oncology Cliniques universitaires Saint Luc MIRO IREC Lab Université catholique de Louvain Brussels Belgium

Department of Radiation Oncology Comprehensive Cancer Center Medical University of Vienna Vienna Austria

Department of Radiation Oncology European Institute of Oncology IRCCS Milan Italy; Department of Oncology and Hemato oncology University of Milan Milan Italy; Department of Oncology and Hemato oncology University of Milan Milan Italy

Department of Radiation Oncology Ghent University Hospital and Ghent University Gent Belgium

Department of Radiation Oncology Hôpital Valais Sion Switzerland

Department of Radiation Oncology Hospital Universitario de La Princesa Health Research Institute Madrid Spain

Department of Radiation Oncology Hospital Universitario Reina Sofia Cordoba Spain

Department of Radiation Oncology Inselspital University Hospital Bern Switzerland; Department of Radiation Oncology University of Bern Bern Switzerland

Department of Radiation Oncology Institute of Oncology Ljubljana Slovenia; Faculty of Medicine University of Ljubljana Ljubljana Slovenia

Department of Radiation Oncology Iridium Netwerk Antwerp Belgium

Department of Radiation Oncology Istituti Clinici Scientifici Maugeri IRCCS Pavia Italy

Department of Radiation Oncology Oncology Institute of Southern Switzerland Ente Ospedaliero Cantonale Bellinzona Switzerland; Faculty of Medicine University of Geneva Geneva Switzerland

Department of Radiation Oncology Onze Lieve Vrouwziekenhuis Aalst Belgium

Department of Radiation Oncology Radboud University Medical Center Nijmegen Netherlands

Department of Radiation Oncology University Hospital Zurich Zurich Switzerland

Department of Radiation Oncology University Hospital Zurich Zurich Switzerland; Centre for Radiation Oncology KSA KSB Cantonal Hospital Aarau Aarau Switzerland

Department of Radiation Oncology Vall d'Hebron University Hospital Barcelona Spain

Department of Radiotherapy Oncology Leuvens Kanker Instituut Universitair Ziekenhuis Leuven Leuven Belgium

Institute of Radiation Oncology Cantonal Hospital Graubünden Chur Switzerland

Lung Unit The Royal Marsden London UK

Radiation Oncology Department Santa Lucia General University Hospital Cartagena Spain

Radiotherapy and Radiosurgery Department IRCCS Humanitas Research Hospital Milan Italy

Service Radio Oncologie Neuchåtel Hôpital Network La Chaux de Fonds Switzerland

Citace poskytuje Crossref.org