OligoCare (EORTC 1822-RP) is collecting evidence for best practice in the radical (radiation) treatment of oligometastatic disease, where the cancer has metastasized to a limited number of organs.
Despite its almost universal use, the level of evidence supporting radical local treatment in general for oligometastatic patients and stereotactic radiotherapy in particular is low. Uncertainties and variability in practice are therefore huge and it seems highly unlikely or even impossible that these issues will be solved within the traditional framework of prospective randomised trials.
OligoCare is a pragmatic observational cohort study to evaluate radical radiotherapy for patients with oligometastatic disease. The main objective is to identify patient, tumour, diagnostic and treatment characteristics impacting overall survival.
The first primary disease types to be studied are non-small cell lung cancer (NSCLC), breast cancer, prostate cancer and colorectal cancer.
ReCare (EORTC 2011-RP) will gather real-world data on patients treated with high-dose re-irradiation for local recurrence, new primary or secondary cancer. With the advent of modern radiotherapy techniques, high-dose re-radiotherapy is more frequently applied, although clinical evidence for its efficacy is scarce and data on safe dose constraints are practically non-existent, apart from very few exceptions.
Therefore, the currently available data does not allow firm assumptions on the safety and efficacy of high-dose re-irradiation, and cannot provide proper evidence to guide clinical practice and inform on consistent standards of care.
Within the current ReCare cohort, re-irradiation is considered with the following general assumptions:
“Re-irradiation” is defined as a therapeutic dose of radiation delivered to a region/organ which has previously received a therapeutic radiation dose where the summation of the first and the second course carries a risk of a clinical relevant morbidity.
“High-dose” is defined as re-irradiation to a minimum prescription dose equivalent to 50 Gy EQD2.
Submission of DICOM-RT plans from previous radiotherapy will be encouraged but not mandated. There are no restrictions regarding the techniques applied for re-irradiation treatment, i.e. EBRT, brachytherapy, particle therapy, etc. are all allowed.