ESTRO-EORTC expert guideline on target delineation and radiotherapy details for stage I–III small cell lung cancer

作者：Antonin Levy, Cécile Le Péchoux, Bjørn Henning Grønberg, Andreas Rimner, Fabio Y. Moraes, Valeria Dionisi, Jessica Menis, Pedro Rocha, Noemi Reguart, Coen Hurkmans, Sara Ramella, B. Slotman, Corinne Faivre-Finn · 发表于：Radiotherapy and Oncology · 年份：2026 · DOI：10.1016/j.radonc.2026.111516 · 被引用次数：1 · 研究领域：Lung Cancer Research Studies、Lung Cancer Diagnosis and Treatment、Radiomics and Machine Learning in Medical Imaging

INTRODUCTION: Stage I-III limited-stage small cell lung cancer (SCLC) is a highly aggressive yet potentially curable disease with concurrent chemoradiotherapy. Thoracic radiation therapy (RT) plays a central role in the management of stage I-III SCLC; however significant variation exists in staging, target volume delineation, dose prescription, and integration with systemic therapy. This document provides an updated European recommendations on the use of RT in stage I-III SCLC, reflecting recent evidence and advancements in clinical practice. MATERIAL AND METHODS: A panel of European experts was convened under the auspices of the ESTRO Guidelines Committee, in collaboration with EORTC Lung Cancer Group, and to review the available evidence and develop recommendations. Key topics addressed included disease staging, radiotherapy planning and delivery, and the integration with chemotherapy and immunotherapy. RESULTS: Accurate staging should include PET-CT and brain MRI. Thoracic RT should be initiated early during chemotherapy. Standard dose schedules include 45 Gy in 30 fractions (BID) or 66 Gy in 33 fractions once daily, using conformal techniques such as IMRT/VMAT, involved field nodal irradiation, respiratory motion management (e.g., 4D-CT, breath-hold) and image guidance (e.g., cone-beam CT [CBCT]). Concurrent chemotherapy with 4-6 cycles platinum-etoposide followed by consolidation durvalumab for up to two years is the standard of care in fit patients. Prophylactic cerebra...