Clinical trial endpoints for metastases-directed therapy in oligometastatic cancer: a review and Delphi consensus on behalf of the EORTC-ESTRO OligoCare consortium.

However, evaluating the impact of metastases-directed therapies (MDTs) on overall survivalor quality of life is often challenging.

然而，评估转移定向治疗（MDTs）对总生存或生活质量的影响往往具有挑战性。

Current clinical trials use a wide range of primary endpoints that might not be validated or suited to MDT.

当前的临床试验使用了一系列广泛的初级终点，这些终点可能未经验证或不适合多学科团队(MDT)。

To address this issue, we did a systematic reviewof international trial registries, alongside a Delphi consensus process involving 30 experts and five patient representatives.

为了解决这个问题，我们对国际试验注册处进行了系统审查，并进行了一项涉及30位专家和五位患者代表的德尔菲共识过程。

The aim was to identify preferred primary endpoints for MDT trials in oligometastatic disease, regardless of tumour type.

本研究旨在确定在寡转移性疾病中，多学科团队试验首选的主要终点，不受肿瘤类型的影响。

Overall survivaland progression-free survivalwere the most frequently used endpoints across the 121 comparative trials reviewed.

在审查的121项比较试验中，总生存和无进展生存是最常用的终点。

Over four Delphi consensus rounds, overall survivalhad the highest level of agreement, although its limitations as a sole endpoint were emphasised.

在四轮Delphi共识过程中，尽管强调了其作为单一终点的局限性，总生存期（overall survival）仍获得了最高水平的一致性。

In addition to the widely used progression-free survivalendpoint, polymetastatic progression-free survivaland start-or-switch of systemic therapy-free survival also reached consensus, particularly for trials integrating systemic therapies.

除了广泛使用的无进展生存期（progression-free survival）终点外，多发转移无进展生存期（polymetastatic progression-free survival）和开始或切换系统治疗无进展生存期（start-or-switch of systemic therapy-free survival）也达成了共识，特别是在整合系统治疗的试验中。

Both polymetastatic progression-free survivaland systemic therapy-free survival permit repeat MDT without classifying it as treatment failure.

多发性转移无进展生存期和系统治疗无进展生存期均允许重复进行多学科团队讨论，而不将其视为治疗失败。

Patient representatives highlighted the importance of time-to-deterioration of quality of life.

患者代表强调了生活质量下降时间的重要性。

This consensus supports overall survivalas a primary endpoint and, in addition to progression-free survival, recommends polymetastatic progression-free survivaland systemic therapy-free survival, especially in combination with systemic therapies.

本共识支持将总生存作为主要终点，并且除了无进展生存外，还推荐使用多发性转移无进展生存和系统治疗无进展生存，特别是在与系统治疗相结合时。

Adopting these endpoints will make MDT trials more relevant, comparable, and patient-centred, thereby empowering future clinical and policy decisions.

采用这些终点将使多学科团队（MDT）试验更具相关性、可比性，并以患者为中心，从而为未来的临床和政策决策提供支持。