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RSS SRS guideline: up to 15 lesions, β€3 cm and β€14 cc, are SRS-suitable. Fractionate 2-4 cm lesions (27 Gy/3 fx or 30 Gy/5 fx); above 4 cm, surgery first.
CNS carried the day: RSS and ISRS SRS guidelines both require planning MRI β€7 days pre-SRS, each resting on largely observational or single-institution evidence. ASTRO think tank: germline DNA-repair variants should not alter indicated RT, except young deleterious ATM carriers. Breast: consecutive-day 30 Gy/5 fx VMAT PBI (N=50) shows G1-only toxicity at median 4.5 yr.
read the full digest βStudies Β· 278
- Implications of Genetic Testing on Radiation Therapy DecisionsASTRO think tank consensus: heterozygous germline DNA-repair variants (BRCA1/2, PALB2, CHEK2, RAD50) and VUS should not alter indicated RT; young deleterious ATM carriers are the exception.
- ISRS Technical Guidelines: SRS for Small Brain Metastases (β€1 cm)Sub-mm geometric accuracy, β€1 mm E2E tolerance, 5% dosimetric accuracy and MRI β€7 days pre-SRS anchor ISRS physics consensus for β€1 cm brain mets.
- Case-Based Radiosurgery Society Practice Guideline: SRS for Brain MetastasesUp to 15 lesions, β€3 cm and β€14 cc are SRS-suitable. Fractionate 2-4 cm lesions (27 Gy/3 fx or 30 Gy/5 fx). Above 4 cm, surgery comes first.
- Natural History of DCIS of the Breast14β53% of DCIS misdiagnosed as benign and left after biopsy alone progressed to invasive cancer over 10+ yr; precise progression rates not estimable.
- APBI-IMRT-Florence Technique Update (VMAT)30 Gy/5 consecutive-fraction VMAT PBI, N=50: G1-only toxicity (acute 32%, late 16%) at median 4.5 yr f/u, no G>1 events.
- ASTRO Clinical Practice Guideline: Radiation Therapy for Brain MetastasesSRS strongly recommended for ECOG 0-2 with up to 4 intact mets, conditional for 5-10; HA-WBRT plus memantine strong when WBRT is used.
- International consensus on target volume delineation for sacral metastases and spinal SBRTKappa 0.73 for GTV and 0.59 for CTV across 9 experts and 10 cases; consensus compartment-based sacral CTV built on a new eight-segment classification.
- ESTRO Clinical Practice Guideline: SBRT for Spine Metastases22 recommendations, 5 statements (β₯75% consensus): SBRT above 1x18Gy equivalent (BED10=50Gy10), 2x12Gy conditionally preferred for painful vertebral metastases; mostly moderate/expert-opinion evidencβ¦
- International Delphi consensus for pelvic SABR re-irradiation66% of statements reached consensus among 23 international radiation oncologists; no agreement on a 12-month interval (43%) or cumulative OAR constraints.
- GEC-ESTRO HNS critical review: skin superficial brachytherapy with flaps and customized mouldsThicker bolus permits >5 mm prescription depth: at 5 mm depth, 10 vs 5 mm bolus cuts surface Dmax 148% vs 187%; no dose-PROM data.
- GEC-ESTRO ACROP skin brachytherapy recommendationsConsensus technique guide for skin BT: contact BT for tumours <5 mm deep, interstitial for β₯5 mm or curved surfaces; no single standard schedule recommended.
- ASTRO guideline: definitive and postoperative RT for BCC/cSCCASTRO grades definitive RT strong for non-surgical BCC/cSCC; PORT strong for cSCC adverse features but only conditional for BCC equivalents.