{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:29:14Z","timestamp":1787243354545,"version":"build-2736575974"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Med Oncol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stereotactic body radiotherapy (SBRT) is increasingly used for patients with oligometastatic prostate cancer, yet the optimal target definition, dose, and toxicity profile for rib metastases remain uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We assessed local control (LC), toxicity, and the risk of radiation-induced rib fracture (RF) after SBRT for rib metastases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective multicenter cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed prostate cancer patients with radiologically diagnosed rib metastases treated with SBRT and &gt;=12 months of follow-up. Outcomes were descriptively compared between gross tumor volume (GTV)-only and GTV plus an intraosseous clinical target volume (CTV) margin. Analyses included Kaplan-Meier survival estimates, cumulative incidence functions, and exploratory univariable Cox and logistic regression; no formal equivalence testing or multivariable validation was attempted because event numbers were very low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 102 patients with a median follow-up of 20 months. The 1- and 2-year LC rates were 97.9% and 96.3%, respectively. At 3 years, local progression was 2.1% in the GTV-only group, absent in patients treated with &gt;=10 mm margins, and numerically highest with 3-5 mm CTV margins (13.5%, p=0.022). Among 13 symptomatic patients, pain control was excellent, with complete or partial response in all patients within 6 months. No grade &gt;=3 toxicities occurred. RFs were rare (n=3, 2.9%), comprising one symptomatic Grade 2 event (0.9%) and two asymptomatic Grade 1 events (2.0%). Baseline symptoms and extraosseous infiltration were associated with RF in exploratory univariable analysis, but confidence intervals were wide. Higher PTV dose exposure, particularly PTV D50% (36.9 vs. 31.1 Gy, p=0.041), was also observed among RF cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SBRT for rib metastases from prostate cancer was associated with high LC, pain relief, and low observed toxicity in this retrospective real-world cohort. GTV-only contouring may be feasible in carefully selected patients staged and planned with PSMA-PET\/CT, but the non-randomized design, baseline imbalances, short follow-up, and very low event count preclude drawing conclusions about equivalence or independent validation. RF predictor analyses should be considered exploratory and hypothesis-generating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17588359261476045","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:49:52Z","timestamp":1787071792000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Stereotactic radiotherapy for rib metastases from prostate cancer: A multicenter real-world analysis of local control, pain response, and treatment tolerance (RIBRISK)"],"prefix":"10.1177","volume":"18","author":[{"given":"Mateusz","family":"Bilski","sequence":"first","affiliation":[{"name":"Medical University of Lublin"},{"name":"Affidea Nu-med Center of Oncology Diagnostics and Therapy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Mastroleo","sequence":"additional","affiliation":[{"name":"Mayo Clinic"},{"name":"University of 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Traumatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Peszy\u0144ska-Piorun","sequence":"additional","affiliation":[{"name":"Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Ponikowska","sequence":"additional","affiliation":[{"name":"Saint John\u2019s Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Fijuth","sequence":"additional","affiliation":[{"name":"Medical University of Lodz"},{"name":"Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara Alicja","family":"Jereczek Fossa","sequence":"additional","affiliation":[{"name":"University of Milan"},{"name":"European Institute of Oncology 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