European French-speaking study from the GEMO group on bone metastases management: a special focus on external beam radiotherapy practice survey.
OBJECTIVE
This study seeks to perform a survey of patterns of practice among the different physicians involved in the bone metastases management, with special focus on external beam radiotherapy (EBRT).


METHODS
A questionnaire about bone metastases based on clinical cases and supplemented with general questions, including medical therapies, EBRT and metabolic radiotherapy strategies, surgery, and supportive care approaches, was sent to 4,706 French-speaking physicians in Belgium, France, Luxemburg, and Switzerland.


RESULTS
Overall, 644 questionnaires were analyzed. Twenty-eight percent concerned the radiotherapy approach and were judged adequate to respond to the part dedicated to EBRT. Sixty-nine percent of physicians used a total dose irradiation of 30 Gy delivered in ten fractions. A large majority (75%) used two opposed fields prescribed at mid-depth (30%), or with non-equally weighted fields (45%). Seventy percent irradiated also above and below the concerned vertebra. A dosimetry planning treatment was done in 85% and high-energy megavoltage photons were used in 42%. Moreover, 54% physicians used short course radiotherapy in routine.


CONCLUSIONS
Radiotherapy remains the mainstay of treatment of bone metastases, but there is substantial heterogeneity in clinical practice. Guidelines and treatment protocols are required to improve the treatment quality.
Magné
Nicolas
N
Département de Radio-Oncologie, Institut Jules Bordet, Bruxelles, Belgium, nicolas.magne@igr.fr.
Chargari
Cyrus
C
Mirimanoff
René Olivier
RO
Olivier
Pierre
P
Vuillez
Jean Philippe
JP
Tubiana-Hulin
Michèle
M
Body
Jean Jacques
JJ
Lagrange
Jean Léon
JL
D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D002985:Clinical Protocols; D005060:Europe; D019538:Health Care Surveys; D006801:Humans; D007802:Language; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D011879:Radiotherapy Dosage; D011795:Surveys and Questionnaires
J Natl Cancer Inst. 2005 Jun 1;97(11):798-804
15928300
Int J Radiat Oncol Biol Phys. 1998 Aug 1;42(1):161-7
9747834
Radiother Oncol. 1995 Mar;34(3):179-84
7631024
Int J Radiat Oncol Biol Phys. 1998 Mar 15;40(5):1117-24
9539567
Int J Radiat Oncol Biol Phys. 1999 Apr 1;44(1):1-18
10219789
J Clin Oncol. 2007 Apr 10;25(11):1423-36
17416863
Radiother Oncol. 2000 Sep;56(3):305-14
10974379
Int J Radiat Oncol Biol Phys. 1999 Oct 1;45(3):715-9
10524427
Radiother Oncol. 2000 Sep;56(3):279-81
10974375
Bone. 1992;13 Suppl 1:S57-62
1581121
Cochrane Database Syst Rev. 2004;(2):CD004721
15106258
Int J Radiat Oncol Biol Phys. 2003 Mar 1;55(3):594-605
12573746
Radiother Oncol. 1999 Aug;52(2):101-9
10577695
Clin Oncol (R Coll Radiol). 2001;13(2):82-4
11373883
Radiother Oncol. 1999 Aug;52(2):111-21
10577696
Cancer. 1985 Apr 1;55(7):1468-72
2579716
Int J Radiat Oncol Biol Phys. 2005 Apr 1;61(5):1473-81
15817353
Int J Radiat Oncol Biol Phys. 2010 Nov 1;78(3):855-9
20171810
CA Cancer J Clin. 2008 Jul-Aug;58(4):245-59
18354080
Radiother Oncol. 1999 Aug;52(2):95-6
10577693
Int J Radiat Oncol Biol Phys. 1992;23(1):239-44
1572821
Radiother Oncol. 2000 Sep;56(3):315-22
10974380
Int J Radiat Oncol Biol Phys. 1998 Mar 1;40(4):915-21
9531377
J Clin Oncol. 2003 Jun 1;21(11):2156-62
12775741
Radiother Oncol. 1997 Nov;45(2):109-16
9423999
Radiother Oncol. 2000 Sep;56(3):297-303
10974378
Int J Radiat Oncol Biol Phys. 1998 Dec 1;42(5):1119-26
9869238
Int J Radiat Oncol Biol Phys. 2002 Mar 15;52(4):1083-91
11958905