ESTRO ACROP consensus guideline on implementation and practice of stereotactic body radiotherapy for peripherally located early stage non-small cell lung cancer.
- Guckenberger M Department of Radiation Oncology, University Hospital Zürich, Switzerland. Electronic address: matthias.guckenberger@usz.ch.
- Andratschke N Department of Radiation Oncology, University Hospital Zürich, Switzerland.
- Dieckmann K Department of Radiation Oncology, Medical University of Vienna, Austria.
- Hoogeman MS Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.
- Hoyer M Department of Radiation Oncology, Aarhus University Hospital, Denmark.
- Hurkmans C Department of Radiation Oncology, Catharina Hospital, Eindhoven, Netherlands.
- Tanadini-Lang S Department of Radiation Oncology, University Hospital Zürich, Switzerland.
- Lartigau E Department of Radiation Oncology, Centre Oscar Lambret, Lille, France.
- Méndez Romero A Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.
- Senan S Department of Radiation Oncology, VU University Medical Center, Amsterdam, Netherlands.
- Verellen D Department of Radiation Oncology, UZ Brussel (VUB), Belgium.
- 2017-07-09
Published in:
- Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. - 2017
ESTRO ACROP guideline
Early stage NSCLC
Peripheral location
SBRT
Carcinoma, Non-Small-Cell Lung
Comorbidity
Dose Fractionation, Radiation
Humans
Lung Neoplasms
Neoplasm Staging
Radiation Oncology
Radiosurgery
English
BACKGROUND
Stereotactic body radiotherapy (SBRT) has become the standard of care for medically inoperable patients with peripherally located, early stage non-small cell lung cancer (NSCLC), and for those refusing surgical resection. Despite the availability of national and international guidelines, there exists substantial variability in many aspects of SBRT practice.
METHODS
The ESTRO ACROP guideline is based on a questionnaire covering all aspects of SBRT implementation and practice (n=114 items). The questionnaire was answered by the 11 faculty members of the ESTRO course "Clinical practice and implementation of image-guided SBRT" and their 8 institutions.
RESULTS
Agreement by >50% of the institutions was achieved in 72% of all items. Only 8/57 technologies and techniques were identified as mandatory for SBRT while 32/57 were considered as optional. In contrast, quality-assurance related elements were considered as mandatory in 12/24 items. A consensus of risk-adapted SBRT fractionation was achieved with 3×15Gy for peripherally located lesions and 4×12Gy (PTV D95-D99; Dmax <125% to <150%) for lesions with broad chest wall contact. For patients free from severe comorbidities and with favourable long-term OS expectancy, use of the maximum tolerated dose of 3×18Gy should be considered.
CONCLUSIONS
This ACROP guideline achieved detailed recommendations in all aspects of SBRT implementation and practice, which will contribute to further standardization of SBRT for peripherally located early stage NSCLC.
Stereotactic body radiotherapy (SBRT) has become the standard of care for medically inoperable patients with peripherally located, early stage non-small cell lung cancer (NSCLC), and for those refusing surgical resection. Despite the availability of national and international guidelines, there exists substantial variability in many aspects of SBRT practice.
METHODS
The ESTRO ACROP guideline is based on a questionnaire covering all aspects of SBRT implementation and practice (n=114 items). The questionnaire was answered by the 11 faculty members of the ESTRO course "Clinical practice and implementation of image-guided SBRT" and their 8 institutions.
RESULTS
Agreement by >50% of the institutions was achieved in 72% of all items. Only 8/57 technologies and techniques were identified as mandatory for SBRT while 32/57 were considered as optional. In contrast, quality-assurance related elements were considered as mandatory in 12/24 items. A consensus of risk-adapted SBRT fractionation was achieved with 3×15Gy for peripherally located lesions and 4×12Gy (PTV D95-D99; Dmax <125% to <150%) for lesions with broad chest wall contact. For patients free from severe comorbidities and with favourable long-term OS expectancy, use of the maximum tolerated dose of 3×18Gy should be considered.
CONCLUSIONS
This ACROP guideline achieved detailed recommendations in all aspects of SBRT implementation and practice, which will contribute to further standardization of SBRT for peripherally located early stage NSCLC.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1016/j.radonc.2017.05.012
- PMID 28687397
- Persistent URL
- https://sonar.ch/global/documents/298621
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