Oligometastatic Disease in Context of the Radiation Oncology Alternative Payment Model: Implications for Local Consolidative Therapy

Ning, Matthew S.; Boyce-Fappiano, David; Thaker, Nikhil G.

doi:10.1200/op.21.00549

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…The oligometastatic patient population is estimated to grow by 2% each year. 54 The movement of local consolidative therapy toward short-course stereotactic ablative and radiosurgical treatment for multiple lesions is a paradigm shift across a variety of histologies, and the use of the technique has increased 4-fold in the past decade. 54 It is theorized that due to locally advanced ablative therapies, targeting existing metastatic disease is decreasing morbidity and increasing survival.…”

Section: Environmentalmentioning

confidence: 99%

“…54 The movement of local consolidative therapy toward short-course stereotactic ablative and radiosurgical treatment for multiple lesions is a paradigm shift across a variety of histologies, and the use of the technique has increased 4-fold in the past decade. 54 It is theorized that due to locally advanced ablative therapies, targeting existing metastatic disease is decreasing morbidity and increasing survival. There is also evidence to support that advancement in diagnostic quality imaging is increasing the length of life with cancer.…”

Section: Environmentalmentioning

confidence: 99%

See 1 more Smart Citation

An Environmental Scan of Advanced Practice Radiation Therapy in the United States: A PESTEL Analysis

McDonagh,

Tonning,

Freeman

et al. 2023

International Journal of Radiation Oncology*Biology*Physics

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Section: Environmentalmentioning

confidence: 99%

Section: Environmentalmentioning

confidence: 99%

An Environmental Scan of Advanced Practice Radiation Therapy in the United States: A PESTEL Analysis

McDonagh,

Tonning,

Freeman

et al. 2023

International Journal of Radiation Oncology*Biology*Physics

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Caught Between a ROCR and a Hard Place: Improving Proposed Radiation Oncology Alternative Payment Models

Bush,

Liu,

Rula

et al. 2024

International Journal of Radiation Oncology*Biology*Physics

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Oligometastatic Prostate Cancer Treated with Metastasis-Directed Therapy Guided by Positron Emission Tomography: Does the Tracer Matter?

Lanfranchi

Belgioia

Marcenaro

et al. 2023

Cancers

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The superior diagnostic accuracy of [68Ga]Ga-prostate-specific membrane antigen-11 (PSMA) ([68Ga]Ga-PSMA-11) compared to [18F]F-Fluorocholine Positron Emission Tomography/Computed Tomography (PET/CT) in Prostate Cancer (PCa) is established. However, it is currently unclear if the added diagnostic accuracy actually translates into improved clinical outcomes in oligometastatic PCa patients treated with [68Ga]Ga-PSMA-11 PET-guided metastasis-directed therapy (MDT). The present study aimed to assess the impact of these two imaging techniques on Progression-Free Survival (PFS) in a real-world sample of oligometastatic PCa patients submitted to PET-guided MDT. Thirty-seven oligometastatic PCa patients treated with PET-guided MDT were retrospectively enrolled. MDT was guided by [18F]F-Fluorocholine PET/CT in eleven patients and by [68Ga]Ga-PSMA-11 PET/CT in twenty-six. Progression was defined as biochemical recurrence (BR), radiological progression at subsequent PET/CT imaging, clinical progression, androgen deprivation therapy initiation, or death. Clinical and imaging parameters were assessed as predictors of PFS. [18F]F-Fluorocholine PET-guided MDT was associated with significantly lower PFS compared to the [68Ga]Ga-PSMA-11 group (median PFS, mPFS 15.47 months, 95% CI: 4.13–38.00 vs. 40.93 months, 95% CI: 40.93–40.93, respectively; p < 0.05). Coherently, the radiotracer used for PET-guided MDT resulted in predictive PFS at the univariate analysis, as well as the castration-resistant status at the time of MDT and the PSA nadir after MDT. However, in the multivariate analysis, castration resistance and PSA nadir after MDT remained the sole independent predictors of PFS. In conclusion, in the present proof-of-concept study, [68Ga]Ga-PSMA-11 provided higher PFS rates than [18F]F-Fluorocholine imaging in oligometastatic PCa patients receiving PET-guided MDT. Although preliminary, this finding suggests that enlarging the “tip of the iceberg”, by detecting a major proportion of the submerged disease thanks to next-generation imaging may favourably impact the oncological outcome of oligometastatic PCa treated with MDT.

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Oligometastatic Disease in Context of the Radiation Oncology Alternative Payment Model: Implications for Local Consolidative Therapy

Cited by 3 publications

References 22 publications

An Environmental Scan of Advanced Practice Radiation Therapy in the United States: A PESTEL Analysis

An Environmental Scan of Advanced Practice Radiation Therapy in the United States: A PESTEL Analysis

Caught Between a ROCR and a Hard Place: Improving Proposed Radiation Oncology Alternative Payment Models

Oligometastatic Prostate Cancer Treated with Metastasis-Directed Therapy Guided by Positron Emission Tomography: Does the Tracer Matter?

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