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Practice Patterns and Perspectives on Stereotactic Body Radiation Therapy for the Metastatic Spine From Lower- and Middle-Income Countries

We wanted to understand the current practice patterns and stereotactic body radiation therapy (SBRT) utilization for spine metastases in lower- and middle-income countries (LMICs). METHODS: A questionnaire was designed to identify the current practice patterns of treating spine metastases, uptake of...

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Autores principales: Pathak, Rima Sanjay, Tibdewal, Anil, Kinhikar, Rajesh, Wakeham, Katherine, Akbarov, Kamal, Cordero, Lisbeth, Khandavalli, Ashwini, Agarwal, Jai Prakash
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812512/
https://www.ncbi.nlm.nih.gov/pubmed/36103640
http://dx.doi.org/10.1200/GO.22.00167
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author Pathak, Rima Sanjay
Tibdewal, Anil
Kinhikar, Rajesh
Wakeham, Katherine
Akbarov, Kamal
Cordero, Lisbeth
Khandavalli, Ashwini
Agarwal, Jai Prakash
author_facet Pathak, Rima Sanjay
Tibdewal, Anil
Kinhikar, Rajesh
Wakeham, Katherine
Akbarov, Kamal
Cordero, Lisbeth
Khandavalli, Ashwini
Agarwal, Jai Prakash
author_sort Pathak, Rima Sanjay
collection PubMed
description We wanted to understand the current practice patterns and stereotactic body radiation therapy (SBRT) utilization for spine metastases in lower- and middle-income countries (LMICs). METHODS: A questionnaire was designed to identify the current practice patterns of treating spine metastases, uptake of spine SBRT in routine care, dose fractionations commonly used, and the perceived benefits and toxicities of using ablative doses. Individuals registering for a spine SBRT workshop were requested to answer the questionnaire. RESULTS: We received 395 responses from radiation oncologists (ROs) working in 12 different LMICs. The majority of respondents were from an academic institute (57.5%). Two hundred seventy-four respondents further identified themselves from the government/public sector (44.89%), corporate/private sector (47.89%), not-for-profit organization (5.4%), or public-private partnership (5.4%). The respondents indicated that 8.43%, 27.46%, 41.73%, and 10.04% of the spine metastases patients are treated using clinical marking, X-ray–based, 3D conformal radiation therapy, and SBRT, respectively. A third of the respondents did not have any experience of spine SBRT; those with high-volume practice were predominantly from an academic institute. The majority of respondents would use spine SBRT to reduce pain severity (71.9%) and achieve durable pain control (61.01%) in the setting of oligometastases (92.73%) and reirradiation (56.69%). Respondents preferred 3- to 5-fraction regimens (64.9%) over 1-2 fractions (33.68%). The top three reasons for not using spine SBRT were resource constraints (50%), lack of machine (37.11%), and lack of training (27.34%). CONCLUSION: There is heterogeneity in spine SBRT practice and utilization between academic and nonacademic institutes. Resource and infrastructure constraints along with lack of training are limiting the use of SBRT among ROs from LMICs. Collaborative studies from LMICs will help in resolving unique challenges posed by resource constraints.
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spelling pubmed-98125122023-01-05 Practice Patterns and Perspectives on Stereotactic Body Radiation Therapy for the Metastatic Spine From Lower- and Middle-Income Countries Pathak, Rima Sanjay Tibdewal, Anil Kinhikar, Rajesh Wakeham, Katherine Akbarov, Kamal Cordero, Lisbeth Khandavalli, Ashwini Agarwal, Jai Prakash JCO Glob Oncol ORIGINAL REPORTS We wanted to understand the current practice patterns and stereotactic body radiation therapy (SBRT) utilization for spine metastases in lower- and middle-income countries (LMICs). METHODS: A questionnaire was designed to identify the current practice patterns of treating spine metastases, uptake of spine SBRT in routine care, dose fractionations commonly used, and the perceived benefits and toxicities of using ablative doses. Individuals registering for a spine SBRT workshop were requested to answer the questionnaire. RESULTS: We received 395 responses from radiation oncologists (ROs) working in 12 different LMICs. The majority of respondents were from an academic institute (57.5%). Two hundred seventy-four respondents further identified themselves from the government/public sector (44.89%), corporate/private sector (47.89%), not-for-profit organization (5.4%), or public-private partnership (5.4%). The respondents indicated that 8.43%, 27.46%, 41.73%, and 10.04% of the spine metastases patients are treated using clinical marking, X-ray–based, 3D conformal radiation therapy, and SBRT, respectively. A third of the respondents did not have any experience of spine SBRT; those with high-volume practice were predominantly from an academic institute. The majority of respondents would use spine SBRT to reduce pain severity (71.9%) and achieve durable pain control (61.01%) in the setting of oligometastases (92.73%) and reirradiation (56.69%). Respondents preferred 3- to 5-fraction regimens (64.9%) over 1-2 fractions (33.68%). The top three reasons for not using spine SBRT were resource constraints (50%), lack of machine (37.11%), and lack of training (27.34%). CONCLUSION: There is heterogeneity in spine SBRT practice and utilization between academic and nonacademic institutes. Resource and infrastructure constraints along with lack of training are limiting the use of SBRT among ROs from LMICs. Collaborative studies from LMICs will help in resolving unique challenges posed by resource constraints. Wolters Kluwer Health 2022-09-14 /pmc/articles/PMC9812512/ /pubmed/36103640 http://dx.doi.org/10.1200/GO.22.00167 Text en © 2022 by American Society of Clinical Oncology https://creativecommons.org/licenses/by/4.0/Licensed under the Creative Commons Attribution 4.0 License: https://creativecommons.org/licenses/by/4.0/
spellingShingle ORIGINAL REPORTS
Pathak, Rima Sanjay
Tibdewal, Anil
Kinhikar, Rajesh
Wakeham, Katherine
Akbarov, Kamal
Cordero, Lisbeth
Khandavalli, Ashwini
Agarwal, Jai Prakash
Practice Patterns and Perspectives on Stereotactic Body Radiation Therapy for the Metastatic Spine From Lower- and Middle-Income Countries
title Practice Patterns and Perspectives on Stereotactic Body Radiation Therapy for the Metastatic Spine From Lower- and Middle-Income Countries
title_full Practice Patterns and Perspectives on Stereotactic Body Radiation Therapy for the Metastatic Spine From Lower- and Middle-Income Countries
title_fullStr Practice Patterns and Perspectives on Stereotactic Body Radiation Therapy for the Metastatic Spine From Lower- and Middle-Income Countries
title_full_unstemmed Practice Patterns and Perspectives on Stereotactic Body Radiation Therapy for the Metastatic Spine From Lower- and Middle-Income Countries
title_short Practice Patterns and Perspectives on Stereotactic Body Radiation Therapy for the Metastatic Spine From Lower- and Middle-Income Countries
title_sort practice patterns and perspectives on stereotactic body radiation therapy for the metastatic spine from lower- and middle-income countries
topic ORIGINAL REPORTS
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812512/
https://www.ncbi.nlm.nih.gov/pubmed/36103640
http://dx.doi.org/10.1200/GO.22.00167
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