TY - JOUR
T1 - Role of radiotherapy in the management of brain metastases of NSCLC – Decision criteria in clinical routine
AU - Glatzer, Markus
AU - Faivre-Finn, Corinne
AU - De Ruysscher, Dirk
AU - Widder, Joachim
AU - Van Houtte, Paul
AU - Troost, Esther G.C.
AU - Slotman, Ben J.
AU - Ramella, Sara
AU - Pöttgen, Christoph
AU - Peeters, Stephanie T.H.
AU - Nestle, Ursula
AU - McDonald, Fiona
AU - Le Pechoux, Cecile
AU - Dziadziuszko, Rafal
AU - Belderbos, José
AU - Ricardi, Umberto
AU - Manapov, Farkhad
AU - Lievens, Yolande
AU - Geets, Xavier
AU - Dieckmann, Karin
AU - Guckenberger, Matthias
AU - Andratschke, Nicolaus
AU - Süveg, Krisztian
AU - Putora, Paul M.
PY - 2020/11/10
Y1 - 2020/11/10
N2 - BACKGROUND: Whole brain radiotherapy (WBRT) is a common treatment option for brain metastases secondary to non-small cell lung cancer (NSCLC). Data from the QUARTZ trial suggest that WBRT can be omitted in selected patients and treated with optimal supportive care alone. Nevertheless, WBRT is still widely used to treat brain metastases secondary to NSCLC. We analysed decision criteria influencing the selection for WBRT among European radiation oncology experts. METHODS: 22 European radiation oncologist experts in lung cancer as selected by the European Society for Therapeutic Radiation Oncology (ESTRO) for previous projects and by the Advisory Committee on Radiation Oncology Practice (ACROP) were asked to describe their strategies in the management of brain metastases of NSCLC. Treatment strategies were subsequently converted into decision trees and analysed for agreement and discrepancies. RESULTS: 9 decision criteria (suitability for SRS, performance status, symptoms, eligibility for targeted therapy, extra-cranial tumour control, age, prognostic scores and "Zugzwang" (the compulsion to treat)) were identified. WBRT was recommended by a majority of the European experts for symptomatic patients not suitable for radiosurgery or fractionated stereotactic radiotherapy. There was also a tendency to use WBRT in the ALK/EGFR/ROS1 negative NSCLC setting. CONCLUSION: Despite the results of the QUARTZ trial WBRT is still widely used among European radiation oncologist experts.
AB - BACKGROUND: Whole brain radiotherapy (WBRT) is a common treatment option for brain metastases secondary to non-small cell lung cancer (NSCLC). Data from the QUARTZ trial suggest that WBRT can be omitted in selected patients and treated with optimal supportive care alone. Nevertheless, WBRT is still widely used to treat brain metastases secondary to NSCLC. We analysed decision criteria influencing the selection for WBRT among European radiation oncology experts. METHODS: 22 European radiation oncologist experts in lung cancer as selected by the European Society for Therapeutic Radiation Oncology (ESTRO) for previous projects and by the Advisory Committee on Radiation Oncology Practice (ACROP) were asked to describe their strategies in the management of brain metastases of NSCLC. Treatment strategies were subsequently converted into decision trees and analysed for agreement and discrepancies. RESULTS: 9 decision criteria (suitability for SRS, performance status, symptoms, eligibility for targeted therapy, extra-cranial tumour control, age, prognostic scores and "Zugzwang" (the compulsion to treat)) were identified. WBRT was recommended by a majority of the European experts for symptomatic patients not suitable for radiosurgery or fractionated stereotactic radiotherapy. There was also a tendency to use WBRT in the ALK/EGFR/ROS1 negative NSCLC setting. CONCLUSION: Despite the results of the QUARTZ trial WBRT is still widely used among European radiation oncologist experts.
UR - https://www.mendeley.com/catalogue/200c2bfa-8712-3fd1-94a3-6eaec71c04d3/
U2 - 10.1016/j.radonc.2020.10.043
DO - 10.1016/j.radonc.2020.10.043
M3 - Article
SN - 0167-8140
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
ER -