Abstract：
The purpose of this European Society for Radiotherapy and Oncology (ESTRO) project, endorsed by the European Association of Urology, is to explore expert opinion on the management of patients with oligometastatic and oligoprogressive renal cell carcinoma by means of stereotactic ablative radiotherapy (SABR) on extracranial metastases, with the aim of developing consensus recommendations for patient selection, treatment doses, and concurrent systemic therapy. A questionnaire on SABR in oligometastatic renal cell carcinoma was prepared by a core group and reviewed by a panel of ten prominent experts in the field. The Delphi consensus methodology was applied, sending three rounds of questionnaires to clinicians identified as key opinion leaders in the field. At the end of the third round, participants were able to find consensus on eight of the 37 questions. Specifically, panellists agreed to apply no restrictions regarding age (25 [100%) of 25) and primary renal cell carcinoma histology (23 [92%] of 25) for SABR candidates, on the upper threshold of three lesions to offer ablative treatment in patients with oligoprogression, and on the concomitant administration of immune checkpoint inhibitor. SABR was indicated as the treatment modality of choice for renal cell carcinoma bone oligometatasis (20 [80%] of 25) and for adrenal oligometastases 22 (88%). No consensus or major agreement was reached regarding the appropriate schedule, but the majority of the poll (54%-58%) retained the every-other-day schedule as the optimal choice for all the investigated sites. The current ESTRO Delphi consensus might provide useful direction for the application of SABR in oligometastatic renal cell carcinoma and highlight the key areas of ongoing debate, perhaps directing future research efforts to close knowledge gaps.
摘要：
这个欧洲放射治疗和肿瘤学会（ESTRO）项目的目的，由欧洲泌尿外科协会认可，是通过对颅外转移的立体定向消融放疗（SABR）来探索对寡转移和寡进展性肾细胞癌患者的管理的专家意见，目的是为患者选择制定共识建议，治疗剂量,同时进行全身治疗。由一个核心小组准备了关于寡转移肾细胞癌SABR的问卷，并由该领域的十名著名专家组成的小组进行了审查。采用德尔菲共识方法，向被确定为该领域关键意见领袖的临床医生发送三轮问卷。在第三轮结束时，参与者能够就37个问题中的8个达成共识。具体来说,小组成员同意对SABR候选人的年龄（25[100%)/25）和原发性肾细胞癌组织学（23[92%]/25）没有限制，在低进展患者提供消融治疗的三个病变的上限阈值，以及同时施用免疫检查点抑制剂。SABR被认为是肾细胞癌骨寡转移症（25个中的20个[80％]）和肾上腺寡转移症22个（88％）的首选治疗方式。没有就适当的时间表达成共识或主要协议，但是大多数民意调查（54％-58％）保留了每隔一天的时间表，作为所有被调查地点的最佳选择。当前的ESTRODelphi共识可能为SABR在寡转移肾细胞癌中的应用提供有用的方向，并突出了正在进行的辩论的关键领域。也许指导未来的研究工作来缩小知识差距。
