ESTRO clinical practice guideline on high-dose thoracic reirradiation for non-small cell lung cancer

作者：Nicolaus Andratschke, Jonas Willmann, Edy Ippolito, Carlo Greco, Robert Rulach, Eliana Vásquez Osorio, Andreas Rimner, C. Le Péchoux, Jose Belderbos, Max Dahele, Matthias Gückenberger, Gerard G. Hanna, Paul Van Houtte, Yolande Lievens, Ursula Nestle, D. Palma, Christoph Pöttgen, Sara Ramella, Ahmed Salem, Helen Grimes, Tine Schytte, Joost J. Nuyttens, Chan Clara, Stephen Harrow, Charles B. Simone, Umberto Ricardi · 发表于：Radiotherapy and Oncology · 年份：2026 · DOI：10.1016/j.radonc.2026.111707 · 研究领域：Lung Cancer Diagnosis and Treatment、Lung Cancer Treatments and Mutations、Lung Cancer Research Studies

PURPOSE: High-dose thoracic reirradiation is increasingly used in clinical practice for patients with non-small cell lung cancer (NSCLC) in a variety of clinical scenarios ranging from locoregional recurrence to selected metastatic settings. The treatment goals of thoracic reirradiation include durable local control, symptom palliation, and potential cure. Despite growing clinical adoption, high-quality randomised evidence guiding patient selection, treatment delivery, and integration with systemic therapy remains limited. This ESTRO- clinical practice guideline aims to provide expert consensus recommendations for high-dose thoracic reirradiation in NSCLC based on the available literature and structured expert agreement. MATERIALS AND METHODS: The guideline was developed by an international, interdisciplinary panel of experts in thoracic radiation oncology and reirradiation, including specialists in radiation oncology, clinical oncology, and medical physics from Europe and North America. A structured modified Delphi consensus process was used to derive and refine recommendations and statements addressing predefined key clinical questions covering patient selection, diagnostic workup, target definition, dose and fractionation, treatment planning and delivery, cumulative dose assessment, combination with systemic therapy, and follow-up. RESULTS: A total of 42 consensus recommendations and statements were derived across eight key questions. Recommendations emphasise careful pati...