Table 3.
PRT Normality Model Summary—Normality model PRT indications: palliative emergencies
| Emergencies | ||||||
|---|---|---|---|---|---|---|
| Reference | Main Prescriptive Indication | Alternative | Additional Statement (if any) | % Consensus Vote* | ||
| A = Agreement (1 + 2) | ||||||
| D = Disagreement (3 + 4) | ||||||
| SA = Strong Agreement (1) | ||||||
| SD = Strong Disagreement (4) | ||||||
| E1 Metastatic Epidural Spinal Cord Compression (MESCC) | ||||||
| QE1e | AIRO Pall | 8 Gy/1fx8Gy (Maranzano [19]) | Preferable for alternative: | BID option can be considered balancing pt and department’s logistic, being suitable for hospitalized pt but not limited to those only | A = 100% [SA = 92%] | D = 0% [SD = 0%] |
| • 20 Gy/5fx4Gy | ||||||
| Secondary alternative option: | ||||||
| • 20 Gy/4fx5GyBID [SHARON project [22, 23]] | ||||||
| • 6 Gy/1fx6Gy | ||||||
| E2 Hemostasis (including Hemoptysis) | ||||||
| QE2h | AIRO Pall | H&N cancer bleeding: | Preferable for alternative: | – | A = 100% [SA = 42%] | D = 0% [SD = 0%] |
| • 20 Gy/5fx4Gy | • 20 Gy/4fx5Gy BID | |||||
| [SHARON project [28]] | ||||||
| Secondary alternative option: | ||||||
| • 44.4 Gy/12fx3,7 Gy | ||||||
| • 8 Gy/1fx8Gy | ||||||
| QE2i | AIRO Pall | Esophageal cancer bleeding: | 20 Gy/5fx4Gy | – | A = 100% [SA = 42%] | D = 0% [SD = 0%] |
| • 6 Gy/1fx6Gy | ||||||
| • 8 Gy/1fx8Gy | ||||||
| • 12 Gy/4fx3Gy BID [SHARON project [23]] | ||||||
| QE2j | AIRO Pall | Gastric cancer bleeding: | 20 Gy/5fx4Gy | – | A = 84% [SA = 42%] | D = 16% [SD = 0%] |
| • 6 Gy/1fx6Gy | ||||||
| • 8 Gy/1fx8Gy (with anti-emetic) | ||||||
| QE2l | AIRO Pall | Pelvic malignancies bleeding: 8 Gy/1fx8Gy | Preferable for alternative: | BID option can be considered balancing pt and department’s logistic, being suitable for hospitalized pt but not limited to those only | A = 100% [SA = 50%] | D = 0% [SD = 0%] |
| • 24 Gy/3fx8Gy Day 0, 7, 21 [29] | ||||||
| • 18 Gy/4fx4.5 Gy BID [SHARON project [30]] | ||||||
| Secondary alternative option: | ||||||
| • 18 Gy/3fx6Gy (Day 0, 7, 21) | ||||||
| • 20 Gy/5fx4Gy | ||||||
| • 24 Gy/6fx4Gy | ||||||
| QE2m | AIRO Pall | Hemoptysis: | • 20 Gy/5fx4Gy | – | A = 92% [SA = 75%] | D = 8% [SD = 0%] |
| • 17 Gy/2fx8.5 Gy (weekly) | ||||||
| E3 Mediastinal Syndrome | ||||||
| QE3e | AIRO Pall | Superior vena cava syndrome: | Preferable for alternative: | BID option can be considered balancing pt and department’s logistic, being suitable for hospitalized pt but not limited to those only | A = 100% [SA = 75%] | D = 0% [SD = 0%] |
| • 17 Gy/2fx8.5 Gy weekly [MRC] [32, 33] | • 8 Gy/1fx8Gy | |||||
| • 20 Gy/5fx4Gy | Secondary alternative option: | |||||
| • 20 Gy/4fx5Gy BID [SHARON project [34]] | ||||||
*Consensus Vote: 1 = Strongly Agree; 2 = Agree; 3 = Disagree; 4 = Strongly Disagree
MESCC Metastatic Epidural Spinal Cord Compression; fx fraction; OS: overall Survival; RT Radiotherapy; pt patient; BID bis in die; Q schedule repetition interval; QoL quality of life; SBRT stereotactic body RT; mets metastases; wks weeks; PEG percutaneous endoscopic gastrostomy; WBRT whole brain RT; TMZ Temozolamide; mth months; IMRT-SIB Intensity modulated RT—Simultaneous integrated boost