Survey Code for each physician
1. Are you a practicing radiation oncologist ____ Yes _____ No
(If no then some statement like - Thank you for your time.)
2. What is the location of your practice? (Country drop down list)
(If answer is U.S. then should bring up question asking for input of zip code where primary practice is
located.)
3. Type of center at which you practice
______ Private practice _____ Hospital or Stand Alone Cancer Center ______ Academic Cancer Center
______ Other (VA, Military, etc.)
4. Total number of radiation oncologists in your practice _____
5a. Are you currently treating patients with limited (< 3 mets) extra-cranial metastatic disease with
definitive hypofractionated radiation therapy (>4Gy/fraction)?
___ Yes ___ No
5b. Are you currently treating patients with extensive (> 3 mets) extra-cranial metastatic disease with
hypofractionated radiation therapy (>4Gy/fraction)?
___ Yes ___ No
6. Reflecting on the evidence for Intensity Modulated Radiation Therapy (IMRT) as a technique during
the period of time that IMRT became widely adopted; do you think that the evidence for treating
patients with definitive hypofractionated radiation for limited metastatic disease is similar in strength to
the initial evidence for use of IMRT as a technique?
____ No significantly more evidence for definitive hypofractionated radiation therapy
____ No slightly more evidence for definitive hypofractionated radiation therapy
____ Equal amount of evidence
____ No slightly less evidence for definitive hypofractionated radiation therapy
____ No significantly less evidence for definitive hypofractionated radiation therapy
(If you answered YES to question 5a or 5b, should go to questions 7 through 21.
(If you answered NO to question 5a and 5b, should go to question 22-23).
7. What year did you begin treating patients with definitive hypofractionated radiation for limited
metastatic disease?
Year: ____
8. Approximately how many patients have you treated with definitive hypofractionated radiation for
limited metastatic disease?
On a prospective clinical trial:___
Off Protocol:
1–20 ___20-50 ___ >50
_______1–20 ___20-50 ___ >50
9. What was/were your major reason(s) for using a definitive hypofractionated regimen for treatment of
limited metastatic disease?
____ Demonstration of durable local control of metastatic disease with hypofractionated regimens
____ Patients were not surgical candidates
____ Image guidance facilitated sparing of normal structures
____ To perform clinical research
____ Other (please specify): _______
10. Which of the following anatomic sites have you have treated with definitive hypofractionated
radiation?
____ Lung ____ Liver ____ Spine ____ Adrenal gland ____Bone
____ Other (please specify): _____
11. Do you think there is a benefit to using regimens with 5 fractions or less as compared to 10
fractions or more for definitive treatment of limited metastatic disease?
____ Yes _____ No
12. What fractionation scheme do you typically utilize?
Please specify: _______
13. How many lesions are you generally willing to treat with definitive hypofractionated radiation in a
single course?
____ 1 ____ 2-3 ____ > 3
14. Are you willing to offer a second course of hypofractionated radiation to a new metastatic site
following limited metastatic progression?
____ Yes _____ No
15. If 2 lesions are in close proximity with potential dose overlap are you willing to treat with definitive
hypofractionated radiation?
____ Yes ____ No _____ Maybe (Please specify):_____
If “yes” to above does your radiation dose to each site:
___ Remain unchanged ____Increase ___Decrease
16. What, if any, adjacent normal tissues would prevent you from treating a patient with definitive
hypofractionated radiation therapy for limited metastatic disease?
_____ Heart _____ Lungs _____ Spinal Cord _____ Small Bowel _____Kidneys
_____ Other(Please Specify):_____
17. Do surgeons at your institution routinely perform metastectomy for extra-cranial limited metastatic
disease?
_____ Yes _____ No
If you answered yes to the above question please answer question 16.
18. Do you think that having surgeons that routinely perform metastasectomy at your institution
increases or decreases your opportunity to treat limited metastatic disease with radiation?
_____ Increases _____ Decreases _____ Neither
19. What treatment planning system do you use?
Please specify:_______
20. Are you planning to:
____ Increase your use of definitive hypofractionated radiation for limited metastatic disease
____ Maintain your current level of utilization of definitive hypofractionated radiation for limited
metastatic disease
____ Decrease your current level of utilization of definitive hypofractionated radiation for limited
metastatic disease
21. If you are planning to decrease or stop the use of definitive hypofractionated radiation therapy for
limited metastatic disease, what is (are) your major reason(s) for doing so (check all that apply)?
____ Time/effort associated with treatment planning
____ Compensation does not warrant time and effort
____ Lack of clinical efficacy
____ Too few patients with oligometastatic disease
____ Potential toxicities of treatment
____ Other (Please specify): ______
____ NA
Questions 22 and 23 should be answered only if answer to 5a and 5b was NO.
22. What is (are) the major reason(s) you are not currently treating patients with hypofractionated
radiation therapy for limited metastatic disease? (check all that apply)?
____Lack of necessary equipment for sufficient image guidance.
____Insufficient staff
____ Too much time/effort with treatment planning.
____ Lack of convincing data to support the use of HIGRT
____ Difficulty with reimbursement
____ Other (Please specify): ____
23. Are you planning to treat patients with definitive hypofractionated radiation for limited metastatic
disease in the future?
____ Yes ____ No
(If you answered yes to question 23, then prompt to answer questions 24 and 25.)
24. When do you expect to begin treating patients with definitive hypofractionated radiation for limited
metastatic disease?
____Within 1 year
____1–3 years
____3–5 years
____ >5 years
25. What is (are) your major reason(s) for planning to start treating patients with definitive
hypofractionated radiation therapy for limited metastatic disease?
(check all that apply):
____To improve clinical outcomes
____ To gain a competitive advantage over other centers in your region
____ To remain competitive with other centers
____ For clinical research purposes
____ Other (please specify):