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3. Preoperative Magnetic Resonance Guided Single-Dose Partial Breast Irradiation: 5-Year Results of the Prospective Single-Arm ABLATIVE Trial

Author

Civil, Yasmin A., Vasmel, Jeanine E., Charaghvandi, Ramona K., Houweling, Anette C., Vreuls, Celien P.H., van Diest, Paul J., Witkamp, Arjen J., Doeksen, Annemiek, van Dalen, Thijs, Felderhof, Joeke, van Dam, Iris, Slotman, Ben J., Kirby, Anna M., Verkooijen, Helena M., van der Velde, Susanne, van der Leij, Femke, and van den Bongard, H.J.G. Desirée

Published
2025
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11. Practice Recommendations for Lung Cancer Radiotherapy During the COVID-19 Pandemic: An ESTRO-ASTRO Consensus Statement

Author

Guckenberger, Matthias, Belka, Claus, Bezjak, Andrea, Bradley, Jeffrey, Daly, Megan E, DeRuysscher, Dirk, Dziadziuszko, Rafal, Faivre-Finn, Corinne, Flentje, Michael, Gore, Elizabeth, Higgins, Kristin A, Iyengar, Puneeth, Kavanagh, Brian D, Kumar, Sameera, Le Pechoux, Cecile, Lievens, Yolande, Lindberg, Karin, McDonald, Fiona, Ramella, Sara, Rengan, Ramesh, Ricardi, Umberto, Rimner, Andreas, Rodrigues, George B, Schild, Steven E, Senan, Suresh, Simone, Charles B, Slotman, Ben J, Stuschke, Martin, Videtic, Greg, Widder, Joachim, Yom, Sue S, and Palma, David

Subjects
Lung, Prevention, Cancer, Lung Cancer, Good Health and Well Being, COVID-19, Consensus, Coronavirus Infections, Humans, Lung Neoplasms, Medical Oncology, Pandemics, Pneumonia, Viral, Practice Guidelines as Topic, Risk Management, Societies, Medical, Triage, Other Physical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Oncology & Carcinogenesis
Abstract

BackgroundThe COVID-19 pandemic has caused radiotherapy resource pressures and led to increased risks for lung cancer patients and healthcare staff. An international group of experts in lung cancer radiotherapy established this practice recommendation pertaining to whether and how to adapt radiotherapy for lung cancer in the COVID-19 pandemic.MethodsFor this ESTRO & ASTRO endorsed project, 32 experts in lung cancer radiotherapy contributed to a modified Delphi consensus process. We assessed potential adaptations of radiotherapy in two pandemic scenarios. The first, an early pandemic scenario of risk mitigation, is characterized by an altered risk-benefit ratio of radiotherapy for lung cancer patients due to their increased susceptibility for severe COVID-19 infection, and minimization of patient travelling and exposure of radiotherapy staff. The second, a later pandemic scenario, is characterized by reduced radiotherapy resources requiring patient triage. Six common lung cancer cases were assessed for both scenarios: peripherally located stage I NSCLC, locally advanced NSCLC, postoperative radiotherapy after resection of pN2 NSCLC, thoracic radiotherapy and prophylactic cranial irradiation for limited stage SCLC and palliative thoracic radiotherapy for stage IV NSCLC.ResultsIn a risk-mitigation pandemic scenario, efforts should be made not to compromise the prognosis of lung cancer patients by departing from guideline-recommended radiotherapy practice. In that same scenario, postponement or interruption of radiotherapy treatment of COVID-19 positive patients is generally recommended to avoid exposure of cancer patients and staff to an increased risk of COVID-19 infection. In a severe pandemic scenario characterized by reduced resources, if patients must be triaged, important factors for triage include potential for cure, relative benefit of radiation, life expectancy, and performance status. Case-specific consensus recommendations regarding multimodality treatment strategies and fractionation of radiotherapy are provided.ConclusionThis joint ESTRO-ASTRO practice recommendation established pragmatic and balanced consensus recommendations in common clinical scenarios of radiotherapy for lung cancer in order to address the challenges of the COVID-19 pandemic.

Published
2020

15. Radiation Therapy for Small Cell Lung Cancer: An ASTRO Clinical Practice Guideline.

Author

Simone, Charles, Bogart, Jeffrey, Cabrera, Alvin, Daly, Megan, DeNunzio, Nicholas, Detterbeck, Frank, Faivre-Finn, Corinne, Gatschet, Nancy, Gore, Elizabeth, Jabbour, Salma, Kruser, Tim, Schneider, Bryan, Slotman, Ben, Turrisi, Andrew, Wu, Abraham, Zeng, Jing, and Rosenzweig, Kenneth

Subjects
Female, Humans, Male, Lung Neoplasms, Small Cell Lung Carcinoma
Abstract

PURPOSE: Several sentinel phase III randomized trials have recently been published challenging traditional radiation therapy (RT) practices for small cell lung cancer (SCLC). This American Society for Radiation Oncology guideline reviews the evidence for thoracic RT and prophylactic cranial irradiation (PCI) for both limited-stage (LS) and extensive-stage (ES) SCLC. METHODS: The American Society for Radiation Oncology convened a task force to address 4 key questions focused on indications, dose fractionation, techniques and timing of thoracic RT for LS-SCLC, the role of stereotactic body radiation therapy (SBRT) compared with conventional RT in stage I or II node negative SCLC, PCI for LS-SCLC and ES-SCLC, and thoracic consolidation for ES-SCLC. Recommendations were based on a systematic literature review and created using a consensus-building methodology and system for grading evidence quality and recommendation strength. RESULTS: The task force strongly recommends definitive thoracic RT administered once or twice daily early in the course of treatment for LS-SCLC. Adjuvant RT is conditionally recommended in surgically resected patients with positive margins or nodal metastases. Involved field RT delivered using conformal advanced treatment modalities to postchemotherapy volumes is also strongly recommended. For patients with stage I or II node negative disease, SBRT or conventional fractionation is strongly recommended, and chemotherapy should be delivered before or after SBRT. In LS-SCLC, PCI is strongly recommended for stage II or III patients who responded to chemoradiation, conditionally not recommended for stage I patients, and should be a shared decision for patients at higher risk of neurocognitive toxicities. In ES-SCLC, radiation oncologist consultation for consideration of PCI versus magnetic resonance surveillance is strongly recommended. Lastly, the use of thoracic RT is strongly recommended in select patients with ES-SCLC after chemotherapy treatment, including a conditional recommendation in those responding to chemotherapy and immunotherapy. CONCLUSIONS: RT plays a vital role in both LS-SCLC and ES-SCLC. These guidelines inform best clinical practices for local therapy in SCLC.

Published
2020

19. Role of Postoperative Radiotherapy in the Management for Resected NSCLC – Decision Criteria in Clinical Routine Pre- and Post-LungART

Author

Süveg, Krisztian, Le Pechoux, Cecile, Faivre-Finn, Corinne, Putora, Paul M., De Ruysscher, Dirk, Widder, Joachim, Van Houtte, Paul, Troost, Esther G.C., Slotman, Ben J., Ramella, Sara, Pöttgen, Christoph, Peeters, Stephanie T.H., Nestle, Ursula, McDonald, Fiona, Dziadziuszko, Rafal, Belderbos, José, Ricardi, Umberto, Manapov, Farkhad, Lievens, Yolande, Geets, Xavier, Dieckmann, Karin, Guckenberger, Matthias, Andratschke, Nicolaus, and Glatzer, Markus

Published
2021
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24. Role of radiotherapy in the management of brain metastases of NSCLC – Decision criteria in clinical routine

Author

Glatzer, Markus, Faivre-Finn, Corinne, De Ruysscher, Dirk, Widder, Joachim, Van Houtte, Paul, Troost, Esther G.C., Slotman, Ben J., Ramella, Sara, Pöttgen, Christoph, Peeters, Stephanie T.H., Nestle, Ursula, McDonald, Fiona, Le Pechoux, Cecile, Dziadziuszko, Rafal, Belderbos, José, Ricardi, Umberto, Manapov, Farkhad, Lievens, Yolande, Geets, Xavier, Dieckmann, Karin, Guckenberger, Matthias, Andratschke, Nicolaus, Süveg, Krisztian, and Putora, Paul M.

Published
2021
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25. Technical note: Dosimetry and FLASH potential of UHDR proton PBS for small lung tumors: Bragg‐peak‐based delivery versus transmission beam and IMPT.

Author

van Marlen, Patricia, van de Water, Steven, Slotman, Ben J., Dahele, Max, and Verbakel, Wilko

Subjects
MEDICAL dosimetry, PROTON therapy, STEREOTACTIC radiotherapy, LUNG tumors, TUBERCULOSIS, LUNGS, PROTON beams
Abstract

Background: High‐energy transmission beams (TBs) are currently the main delivery method for proton pencil beam scanning ultrahigh dose‐rate (UHDR) FLASH radiotherapy. TBs place the Bragg‐peaks behind the target, outside the patient, making delivery practical and achievement of high dose‐rates more likely. However, they lead to higher integral dose compared to conventional intensity‐modulated proton therapy (IMPT), in which Bragg‐peaks are placed within the tumor. It is hypothesized that, when energy changes are not required and high beam currents are possible, Bragg‐peak‐based beams can not only achieve more conformal dose distributions than TBs, but also have more FLASH‐potential. Purpose: This works aims to verify this hypothesis by taking three different Bragg‐peak‐based delivery techniques and comparing them with TB and IMPT‐plans in terms of dosimetry and FLASH‐potential for single‐fraction lung stereotactic body radiotherapy (SBRT). Methods: For a peripherally located lung target of various sizes, five different proton plans were made using "matRad" and inhouse‐developed algorithms for spot/energy‐layer/beam reduction and minimum monitor unit maximization: (1) IMPT‐plan, reference for dosimetry, (2) TB‐plan, reference for FLASH‐amount, (3) pristine Bragg‐peak plan (non‐depth‐modulated Bragg‐peaks), (4) Bragg‐peak plan using generic ridge filter, and (5) Bragg‐peak plan using 3D range‐modulated ridge filter. Results: Bragg‐peak‐based plans are able to achieve sufficient plan quality and high dose‐rates. IMPT‐plans resulted in lowest OAR‐dose and integral dose (also after a FLASH sparing‐effect of 30%) compared to both TB‐plans and Bragg‐peak‐based plans. Bragg‐peak‐based plans vary only slightly between themselves and generally achieve lower integral dose than TB‐plans. However, TB‐plans nearly always resulted in lower mean lung dose than Bragg‐peak‐based plans and due to a higher amount of FLASH‐dose for TB‐plans, this difference increased after including a FLASH sparing‐effect. Conclusion: This work indicates that there is no benefit in using Bragg‐peak‐based beams instead of TBs for peripherally located, UHDR stereotactic lung radiotherapy, if lung dose is the priority. [ABSTRACT FROM AUTHOR]

Published
2024
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28. Once daily versus twice-daily radiotherapy in the management of limited disease small cell lung cancer – Decision criteria in routine practise

Author

Glatzer, Markus, Faivre-Finn, Corinne, De Ruysscher, Dirk, Widder, Joachim, Van Houtte, Paul, Troost, Esther G.C., Dahele, MR, Slotman, Ben J., Ramella, Sara, Pöttgen, Christoph, Peeters, Stephanie T.H., Nestle, Ursula, McDonald, Fiona, Le Pechoux, Cecile, Dziadziuszko, Rafal, Belderbos, José, and Putora, Paul M.

Published
2020
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29. Cardiac radioablation—A systematic review

Author

van der Ree, Martijn H., Blanck, Oliver, Limpens, Jacqueline, Lee, Charlie H., Balgobind, Brian V., Dieleman, Edith M.T., Wilde, Arthur A.M., Zei, Paul C., de Groot, Joris R., Slotman, Ben J., Cuculich, Phillip S., Robinson, Clifford G., and Postema, Pieter G.

Published
2020
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32. The role of postoperative thoracic radiotherapy and prophylactic cranial irradiation in early stage small cell lung cancer: Patient selection among ESTRO experts

Author

Putora, Paul M., De Ruysscher, Dirk, Glatzer, Markus, Widder, Joachim, Van Houtte, Paul, Troost, Esther G.C., Slotman, Ben J., Ramella, Sara, Pöttgen, Christoph, Peeters, Stephanie, Nestle, Ursula, McDonald, Fiona, Le Pechoux, Cecile, Dziadziuszko, Rafal, Belderbos, José, and Faivre-Finn, Corinne

Published
2020
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33. Stereotactic radiosurgery for vestibular schwannoma: International Stereotactic Radiosurgery Society (ISRS) Practice Guideline.

Author

Tsao, May N, Sahgal, Arjun, Xu, Wei, De Salles, Antonio, Hayashi, Motohiro, Levivier, Marc, Ma, Lijun, Martinez, Roberto, Régis, Jean, Ryu, Sam, Slotman, Ben J, and Paddick, Ian

Subjects
acoustic, neuroma, schwannoma, systematic review, vestibular, Cancer, Neurosciences
Abstract

ObjectivesThe aim of this systematic review was to develop International Stereotactic Radiosurgery Society (ISRS) consensus guideline statements for vestibular schwannoma.MethodsA systematic review of the literature was performed up to April 2015.ResultsA total of 55 full-text articles were included in the analysis. All studies were retrospective, except for 2 prospective quality of life studies. Five-year tumour control rates with Gamma Knife radiosurgery (RS), single fraction linac RS, or fractionated (either hypofractionated or conventional fractionation) stereotactic radiation therapy (FSRT) were similar at 81-100%. The single fraction RS series (linac or Gamma Knife) with tumour marginal doses between 12 and 14 Gy revealed 5-year tumour control rates of 90-99%, hearing preservation rates of 41-79%, facial nerve preservation rates of 95-100% and trigeminal preservation rates of 79-99%.There were 6 non-randomized studies comparing single fraction RS versus FSRT. There was no statistically significant difference in tumour control; HR=1.66 (95% CI 0.81, 3.42), p =0.17, facial nerve function; HR = 0.67 (95% CI 0.30, 1.49), p =0.33, trigeminal nerve function; HR = 0.80 (95% CI 0.41, 1.56), p =0.51, and hearing preservation; HR = 1.10 (95% CI 0.72, 1.68), p =0.65 comparing single fraction RS with FSRT.Nine quality of life reports yielded conflicting results as to which modality (surgery, observation, or radiation) was associated with better quality of life outcomes.ConclusionsThere are no randomized trials to help guide management of patients with vestibular schwannoma. Within the limitations of the retrospective series, a number of consensus statements were made.

Published
2017

35. Stereotactic body radiotherapy for hepatocellular carcinoma: meta-analysis and International Stereotactic Radiosurgery Society practice guidelines

Author

Bae, Sun Hyun, Chun, Seok-Joo, Chung, Joo-Hyun, Kim, Eunji, Kang, Jin-Kyu, Jang, Won Il, Moon, Ji Eun, Roquette, Isaure, Mirabel, Xavier, Kimura, Tomoki, Ueno, Masayuki, Su, Ting-Shi, Tree, Alison C, Guckenberger, Matthias, Lo, Simon S, Scorsetti, Marta, Slotman, Ben J, Kotecha, Rupesh, Sahgal, Arjun, Louie, Alexander V, Kim, Mi-Sook, Bae, Sun Hyun, Chun, Seok-Joo, Chung, Joo-Hyun, Kim, Eunji, Kang, Jin-Kyu, Jang, Won Il, Moon, Ji Eun, Roquette, Isaure, Mirabel, Xavier, Kimura, Tomoki, Ueno, Masayuki, Su, Ting-Shi, Tree, Alison C, Guckenberger, Matthias, Lo, Simon S, Scorsetti, Marta, Slotman, Ben J, Kotecha, Rupesh, Sahgal, Arjun, Louie, Alexander V, and Kim, Mi-Sook

Abstract

PURPOSE This systematic review and meta-analysis reports on outcomes and hepatic toxicity rates following stereotactic body radiotherapy (SBRT) for liver confined hepatocellular carcinoma (HCC), and presents consensus guidelines regarding appropriate patient management. METHODS AND MATERIALS Using the Preferred Reporting Items for Systemic Review and Meta-analyses guidelines, a systematic review was performed from articles reporting outcomes at ≥5 years published prior to October 2022 from the Embase, MEDLINE, Cochrane, and Scopus databases using the key words terms ("Stereotactic body radiotherapy" OR "SBRT" OR "SABR" OR "Stereotactic ablative radiotherapy") AND ("Hepatocellular carcinoma" OR "HCC"). An aggregated data (AD) meta-analysis was conducted to assess overall survival (OS) and local control (LC) using weighted random effects models. In addition, an individual patient data (IPD) analysis incorporating data from 6 institutions was conducted as its own subgroup analyses. RESULTS Seventeen observational studies, comprising 1889 HCC patients treated with ≤9 SBRT fractions, between 2003 and 2019, were included in the AD meta-analysis. The 3- and 5- year OS rates after SBRT were 57% (95% confidence interval [CI], 47-66%) and 40% (95% CI, 29-51%). The 3- and 5- year LC rates after SBRT were 84% (95% CI, 77-90%) and 82% (95% CI, 74-88%), respectively. Tumor size was the only prognostic factor for LC. Tumor size and region were significantly associated with OS. Five-year LC and OS rates of 79% (95% CI, 0.74-0.84) and 25% (95% CI, 0.20-0.30), respectively, were observed in the IPD analyses. Factors prognostic for improved OS were tumor size <3 cm, eastern region, Child-Pugh score ≤B7, and the Barcelona Clinic Liver Cancer stage of 0 and A. The incidence of severe hepatic toxicity varied according to the criteria applied. CONCLUSIONS SBRT is an effective treatment modality for HCC patients with mature follow up. Clinical practice guidelines were developed on behalf o

Published
2024

36. Interferon- and STING-independent induction of type I interferon stimulated genes during fractionated irradiation

Author

Goedegebuure, Ruben S. A., Kleibeuker, Esther A., Buffa, Francesca M., Castricum, Kitty C. M., Haider, Syed, Schulkens, Iris A., ten Kroode, Luuk, van den Berg, Jaap, Jacobs, Maarten A. J. M., van Berkel, Anne-Marie, van Grieken, Nicole C. T., Derks, Sarah, Slotman, Ben J., Verheul, Henk M. W., Harris, Adrian L., and Thijssen, Victor L.

Published
2021
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40. Consolidative thoracic radiotherapy in stage IV small cell lung cancer: Selection of patients amongst European IASLC and ESTRO experts

Author

Putora, Paul Martin, Glatzer, Markus, De Ruysscher, Dirk, Faivre-Finn, Corinne, Belderbos, José, Besse, Benjamin, Blackhall, Fiona, Califano, Raffaele, Cappuzzo, Federico, de Marinis, Filippo, Dziadiuszko, Rafal, Felip, Enriqueta, Früh, Martin, Garrido, Pilar, Le Pechoux, Cecile, McDonald, Fiona, Nestle, Ursula, Novello, Silvia, Brien, Mary O‘, Paz Ares, Luis, Peeters, Stephanie, Pöttgen, Christoph, Ramella, Sara, Reck, Martin, Troost, Esther G.C., Van Houtte, Paul, Westeel, Virginie, Widder, Joachim, Mornex, Francoise, and Slotman, Ben J.

Published
2019
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41. Prophylactic cranial irradiation in stage IV small cell lung cancer: Selection of patients amongst European IASLC and ESTRO experts

Author

Putora, Paul M., Glatzer, Markus, Belderbos, José, Besse, Benjamin, Blackhall, Fiona, Califano, Raffaele, Cappuzzo, Federico, de Marinis, Filippo, Dziadziuszko, Rafal, Felip, Enriqueta, Faivre-Finn, Corinne, Früh, Martin, Garrido, Pilar, Le Pechoux, Cecila, McDonald, Fiona, Nestle, Ursula, Novello, Silvia, O‘Brien, Mary, Paz Ares, Luis, Peeters, Stephanie, Pöttgen, Christoph, Ramella, Sara, Reck, Martin, Slotman, Ben, Troost, Esther G.C., Van Houtte, Paul, Westeel, Virginie, Widder, Joachim, Mornex, Francoise, and De Ruysscher, Dirk

Published
2019
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43. Stereotactic Body Radiation Therapy for Hepatocellular Carcinoma: Meta-Analysis and International Stereotactic Radiosurgery Society Practice Guidelines

Author

Bae, Sun Hyun, primary, Chun, Seok-Joo, additional, Chung, Joo-Hyun, additional, Kim, Eunji, additional, Kang, Jin-Kyu, additional, Jang, Won Il, additional, Moon, Ji Eun, additional, Roquette, Isaure, additional, Mirabel, Xavier, additional, Kimura, Tomoki, additional, Ueno, Masayuki, additional, Su, Ting-Shi, additional, Tree, Alison C., additional, Guckenberger, Matthias, additional, Lo, Simon S., additional, Scorsetti, Marta, additional, Slotman, Ben J., additional, Kotecha, Rupesh, additional, Sahgal, Arjun, additional, Louie, Alexander V., additional, and Kim, Mi-Sook, additional

Published
2024
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47. Radiation Therapy and Indigenous Peoples in Canada and Australia: Building Paths Toward Reconciliation in Cancer Care Delivery

Author

Chan, Jessica, Griffiths, Kalinda, Turner, Ashley, Tobias, Joshua, Clarmont, Warren, Delaney, Geoff, Hutton, Jonathon, Olson, Robert, Penniment, Michael, Bourque, Jean-Marc, Brundage, Michael, Rodin, Danielle, Slotman, Ben, and Yap, Mei Ling

Subjects
Cancer Research, Radiation, Oncology, Radiology, Nuclear Medicine and imaging
Abstract

Indigenous peoples represent approximately 5% of the world's population and reside in over 90 countries worldwide. They embody a rich diversity of cultures, traditions, languages and relationships with the land that are shared through many generations and that are distinct from those of the settler societies within which they now live. Many Indigenous peoples have a shared experience of discrimination, trauma, and violation of rights, rooted in complex sociopolitical relationships with settler societies that are still ongoing. This results in continuing social injustices and pronounced disparities in health for many Indigenous peoples around the globe. Indigenous peoples exhibit a significantly higher cancer incidence, mortality, and poorer survival compared to non-Indigenous peoples. Cancer services, including radiotherapy, have not been designed to support the specific values and needs of Indigenous populations, resulting in poorer access to cancer services for Indigenous peoples globally across the entire cancer care spectrum. Specific to radiotherapy, available evidence demonstrates disparities in radiotherapy uptake between Indigenous and non-Indigenous patients. Radiotherapy centres are also located disparately further away from Indigenous communities. Studies are limited by a lack of Indigenous-specific data to help inform effective radiotherapy delivery. Recent Indigenous-led partnerships and initiatives have helped to address existing gaps in cancer care, and radiation oncologists play an important role in supporting such efforts. In this article, we present an overview of access to radiotherapy for Indigenous peoples in Canada and Australia, with a focus on strengthening cancer care delivery through education, partnerships, and research.

Published
2023
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48. Stereotactic Body Radiotherapy

Author

Kothari, Gargi, Lo, Simon S., Foote, Matthew, Sahgal, Arjun, Karam, Irene, Lock, Michael, Blom, Gerrit J., Guckenberger, Matthias, Slotman, Ben J., Siva, Shankar, Brady, Luther W., Series Editor, Lu, Jiade J., Series Editor, Heilmann, Hans-Peter, Honorary Editor, Molls, Michael, Honorary Editor, Trombetta, Mark, editor, Pignol, Jean-Philippe, editor, and Montemaggi, Paolo, editor

Published
2018
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