近期，Lancet Oncol发表了由EORTC（欧洲癌症治疗研究组织）与ESTRO（欧洲放射治疗与肿瘤学会）牵头的关于寡转移特征变量及分类系统的专家共识！共有20名该领域专家参与制定。

在PubMed and Embase 检索关于寡转移前瞻性临床试验，检索策略：

 ([“oligometastasis” OR “oligometastatic” OR “oligometastases” OR “oligo­recurrence” OR “oligo recurrent” OR “oligoprogression” OR “oligoprogressive” OR “oligopersistent” OR “oligo­persistence”] AND [“randomised” OR “randomized” OR “prospective”])

完成检索后，26篇文献通过提取其中的inclusion与exclusion条件作为特征变量库，随后进行共识形成；

1st round：通过网络咨询形式（SurveyMonkey and Google Forms），向专家反馈上述收集的特征变量，最后再加上一条开放性的题目

“to describe potential oligometastatic disease characterisation factors and classification factors that had not been identified in the systematic review”

2nd round：研究者将第一轮的意见综合后将结果匿名进一步反馈，并进行核实；

3rd round：通过收集前两轮的特征变量，由专家对每一变量进行评分，1-5分（1=strongly agree; 5=strongly disagree）；只有达到75%以上一致意见的变量才纳入最终panel；同时分析并收集未能达到一致的相关变量，再次进行投票，已确保最终特征变量panel的规范统一；

最终形成的关于寡转移的特征变量panel如下：

建议对寡转移患者进行治疗前，都必须进行以上变量的肿瘤评估！

通过上述的寡转移特征变量，研究组进一步通过三轮Delphi形成寡转移分类共识，结果如下：

Question 1: Does the patient have a history of polymetastatic disease before current diagnosis of oligometastatic disease?

Question 2: Does the patient have a history of oligometastatic disease before the current diagnosis of oligometastatic disease?

Question 3: Has oligometastatic disease been first diagnosed more than 6 months after the primary cancer diagnosis?

Question 4: Is the patient under active systemic therapy at the time of oligometastatic disease diagnosis?

Question 5: Are any oligometastatic lesions progressive on current imaging?

Induced oligometastatic disease ：表示既往有polymetastatic病史

Genuine oligometastatic disease：表示既往无polymetastatic病史，其可进一步分为 repeat oligometastatic disease（既往有寡转移病史）与de-novo oligometastatic disease（首次诊断为寡转移）；

其中de-novo oligometastatic disease根据timeline可分为synchronous与metachronous；

另外，亚分类中的oligorecurrence代表发生在无治疗间隔期；oligoprogression代表发生在全身治疗期间；而oligopersistence代表目前寡转移病灶无进展；

此外，文章还强调患者的寡转移状态是可以相关转变的，如下图：

文章内多次提及，这次所提出的变量及分类系统有待OligoCare临床试验（NCT03818503）中验证其在临床实践中的作用以及其预后相关性；

以下相关内容来自clinical trial网站上关于该临床试验相关信息：

Brief Summary:

The primary objective is the collection of real-world data of cancer patients treated with radiotherapy, to support radiotherapy research and to provide evidence of the role of radiation oncology in a multidisciplinary approach. This is an open ended prospective non-interventional non-therapeutic multi-cohort study.

来源： 肺外学徒：https://mp.weixin.qq.com/s/0-49S9jFs74GaZeL9zG5cQ