Consensus Guidelines

Palliative Bone Metastases (2011) – ASTRO Consensus Guidelines

This guideline provides guidance for patients and physicians regarding the use of radiotherapy in the treatment of bone metastases according to current published evidence and complemented by expert opinion. It investigates the literature regarding effective fractionation schemes; the appropriateness of single fraction radiotherapy involving the spine or other critical structures; long-term side effect risks limiting the use of single fraction therapy; when patients should receive repeat treatment with radiotherapy for peripheral bone metastases; when patients should receive repeat treatment with radiotherapy to spinal lesions causing recurrent pain; the efficacy of highly conformal radiotherapy in the primary treatment of bone metastases; and when highly conformal radiotherapy should be used for repeat treatment of spinal lesions causing recurrent pain. It was concluded that external beam radiotherapy is a successful and time efficient method to palliate pain and/or prevent the morbidity of bone metastases.

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Palliative Thoracic Radiotherapy (2011) – ASTRO Consensus Guidelines

This guideline provides guidance on the use of external beam radiotherapy, endobronchial brachytherapy and concurrent chemotherapy in the setting of palliative thoracic treatment of lung cancer based on available evidence complemented by expert opinion. It investigates the literature regarding dose fractionation in thoracic external beam radiotherapy (EBRT), clinical utility of initial and salvage endobronchial brachytherapy (EBB) and use of concurrent chemotherapy (CC) with palliative thoracic radiotherapy. It was concluded that further prospective clinical investigations with relevant palliative endpoints into the respective roles of EBB and CC/targeted therapy in the thoracic palliation of lung cancer are warranted, given the current state of the medical literature in these areas.

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Palliative Radiotherapy for Brain Metasases (2012) – ASTRO Consensus Guidelines

This guideline systematically reviews the evidence for the radiotherapeutic and surgical management of patients newly diagnosed with intraparenchymal brain metastases.

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