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@ARTICLE{Turcas:306582,
author = {A. Turcas and R. Bodensohn$^*$ and E. Clerici and I.
Desideri and F. Ehret$^*$ and N. Gleim and H. Maciej and P.
Navarria and A. Williamson and J. Wilmann and N. Andratschke
and G. Minniti and M. Niyazi$^*$},
title = {{P}atterns of care in primary brain tumour {R}eirradiation:
{A} survey by the {ESTRO} {CNS} focus {G}roup.},
journal = {Radiotherapy and oncology},
volume = {nn},
issn = {0167-8140},
address = {Amsterdam [u.a.]},
publisher = {Elsevier Science},
reportid = {DKFZ-2025-02623},
pages = {nn},
year = {2025},
note = {epub},
abstract = {Reirradiation is increasingly considered for patients with
recurrent primary brain tumours, yet clinical practices vary
significantly due to limited evidence and a lack of
standardized guidelines. This survey aimed to map European
practice patterns in brain tumour reirradiation.A 23-item
web-based survey was developed by the ESTRO CNS Focus Group
to assess institutional characteristics, clinical
decision-making, and technical aspects of reirradiation.
Distributed via email and social media, the survey collected
responses between June-July 2025. Descriptive statistics
were applied.Eighty responses from 28 European countries
were analysed. High-grade gliomas were the most frequently
reirradiated tumours (>80 $\%),$ followed by meningioma (56
$\%,$ low-grade glioma (49 $\%),$ and ependymoma (44 $\%).$
Conventional photon radiotherapy (RT) was the predominant
technique across all tumour types, with varying use of
hypofractionation, stereotactic RT, and proton therapy.
Target volume definition and margin size varied by
histology, with larger margins and inclusion of
edema/cavities more frequent in gliomas. MRI-CT fusion was
standard for planning. Concurrent systemic treatment was
used mainly in high-grade gliomas. Organ at risk dose
recovery and cumulative constraints were commonly
considered, but threshold values and recovery models
differed. Main barriers included fear of toxicities,
including radiation necrosis and limited evidence.This
survey reveals high heterogeneity in brain tumour
reirradiation practices across Europe, especially regarding
dose, technique, and target definition. Despite shared
principles, consensus is lacking for rarer tumour types.
These findings underscore the need for harmonized guidelines
and prospective data to optimize patient care.},
cin = {TU01 / BE01},
ddc = {610},
cid = {I:(DE-He78)TU01-20160331 / I:(DE-He78)BE01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41290090},
doi = {10.1016/j.radonc.2025.111299},
url = {https://inrepo02.dkfz.de/record/306582},
}