서울의대 / 배선현, 김진호*
Background: Growing evidence suggests that metastasis-directed therapy and/or prostate-directed therapy may benefit patients with oligometastatic prostate cancer (OMPC). Stereotactic body radiotherapy (SBRT) is increasingly used to treat oligometastases in various cancers. The purpose of this study was to investigate the current patterns of curative-intent SBRT for OMPC in Korea.
Methods: A 20-item questionnaire was sent to 326 radiation oncologists in 93 institutions in Korea. Only 1 physician per institution was required to complete the survey. Subsequently, the second survey consisting of 3 clinical scenarios was sent to 64 physicians with clinical experience in SBRT: case 1, cT4N0M1 (direct invasion to two pelvic bones); case 2, cT2N0M1 (three bone metastases); and case 3, solitary spine metastasis after radical prostatectomy.
Results: Seventy-six physicians from 93 institutions (82%) answered the first survey. The multidisciplinary team approach was practiced in 16 institutions (21%). Most physicians (75%) agreed on the definition of oligometastases as limited lesions and/or organs ≤5: 25% agreed with low-volume disease according to CHAARTED trial. During the last year, 49 physicians (64%) treated OMPC patients with curative intent. Sixty four physicians (84%) had a clinical experience with SBRT: 48 (75%) stated that both dose and fraction number should be considered when defining SBRT, whereas others (25%) stated that only fraction size should be considered. Fifty-five faculties (86%) answered the second survey. Physicians agreed with oligometastases in 89% for case 1, in 80% for case 2, and in 100% for case 3. The rate of SBRT application was the highest in case 3 (70%).
Conclusions: There was diversity in the patterns of SBRT for OMPC in Korea. Additional prospective studies are necessary to strengthen evidence regarding role of SBRT in OMPC.
Sun Hyun Bae 1, Won Il Jang 2, Hyun-Cheol Kang 3, Young Il Kim 4, Yong Ho Kim 5, Woo Chul Kim 6, Hee Kwan Lee 7, Jin Ho Kim 3
1Department of Radiation Oncology, Soonchunhyang University College of Medicine, Bucheon, Republic of Korea.
2Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea.
3Seoul National University College of Medicine, Seoul, Republic of Korea.
4Chungnam National University School of Medicine, Daejeon, Republic of Korea.
5International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea.
6Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea.
7Jeonju Jesus Hospital, Jeollabuk-do, Republic of Korea.