Stereotactic body radiotherapy for early-stage non-small-cell lung cancer: American society of clinical oncology endorsement of the American society for radiation oncology evidence-based guideline

Bryan J. Schneider, Megan E. Daly, Erin B. Kennedy, Mara B. Antonoff, Stephen Broderick, Jill Feldman, Shruti Jolly, Bryan Meyers, Gaetano Rocco, Chad Rusthoven, Ben J. Slotman, Daniel H. Sterman, Brendon M. Stiles

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose The American Society for Radiation Oncology (ASTRO) produced an evidence-based guideline on treatment with stereotactic body radiotherapy (SBRT) for patients with early-stage non-small-cell lung cancer. ASCO has a policy and set of procedures for endorsing and/or adapting clinical practice guidelines that have been developed by other professional organizations. Methods The ASTRO Evidence-Based Guideline for Stereotactic Body Radiotherapy for Early-Stage Non- Small-Cell Lung Cancer was reviewed for developmental rigor by methodologists. An ASCO Expert Panel updated the literature search and reviewed the guideline content and recommendations. Results The ASCO Expert Panel determined that the recommendations from the ASTRO guideline, published in 2017, are clear, thorough, and based on the most relevant scientific evidence. ASCO statements and minor modifications were added to enhance the applicability of the ASTRO guideline for the broader ASCO audience. Recommendations For standard operative risk patients with stage I NSCLC, SBRT is not recommended outside of a clinical trial. Lobectomywith systematic lymph node evaluation remains the recommended treatment, although a sublobar resection may be considered in select clinical scenarios. Recommendations are provided regarding the use of SBRT in high operative risk patients and for inoperative patients, including in challenging scenarios where tumors are: centrally located, . 5 cm in diameter, lacking tissue diagnosis, synchronous primary or multifocal, second primary after pneumonectomy, proximal to or involved with mediastinal structures, abutting the chest wall, or recurring after previous treatment. Qualifying statements are included to provide further guidance for implementation, and the importance of a discussion of treatment options among members of the multidisciplinary cancer care team is emphasized. Additional information is available at: Www.asco.org/thoracic-cancer-guidelines and www.asco.org/guidelineswiki.
Original languageEnglish
Pages (from-to)710-719
JournalJournal of Clinical Oncology
Volume36
Issue number7
DOIs
Publication statusPublished - 2018

Cite this

Schneider, Bryan J. ; Daly, Megan E. ; Kennedy, Erin B. ; Antonoff, Mara B. ; Broderick, Stephen ; Feldman, Jill ; Jolly, Shruti ; Meyers, Bryan ; Rocco, Gaetano ; Rusthoven, Chad ; Slotman, Ben J. ; Sterman, Daniel H. ; Stiles, Brendon M. / Stereotactic body radiotherapy for early-stage non-small-cell lung cancer: American society of clinical oncology endorsement of the American society for radiation oncology evidence-based guideline. In: Journal of Clinical Oncology. 2018 ; Vol. 36, No. 7. pp. 710-719.
@article{4c60e2f730024b26bae2c032607e264a,
title = "Stereotactic body radiotherapy for early-stage non-small-cell lung cancer: American society of clinical oncology endorsement of the American society for radiation oncology evidence-based guideline",
abstract = "Purpose The American Society for Radiation Oncology (ASTRO) produced an evidence-based guideline on treatment with stereotactic body radiotherapy (SBRT) for patients with early-stage non-small-cell lung cancer. ASCO has a policy and set of procedures for endorsing and/or adapting clinical practice guidelines that have been developed by other professional organizations. Methods The ASTRO Evidence-Based Guideline for Stereotactic Body Radiotherapy for Early-Stage Non- Small-Cell Lung Cancer was reviewed for developmental rigor by methodologists. An ASCO Expert Panel updated the literature search and reviewed the guideline content and recommendations. Results The ASCO Expert Panel determined that the recommendations from the ASTRO guideline, published in 2017, are clear, thorough, and based on the most relevant scientific evidence. ASCO statements and minor modifications were added to enhance the applicability of the ASTRO guideline for the broader ASCO audience. Recommendations For standard operative risk patients with stage I NSCLC, SBRT is not recommended outside of a clinical trial. Lobectomywith systematic lymph node evaluation remains the recommended treatment, although a sublobar resection may be considered in select clinical scenarios. Recommendations are provided regarding the use of SBRT in high operative risk patients and for inoperative patients, including in challenging scenarios where tumors are: centrally located, . 5 cm in diameter, lacking tissue diagnosis, synchronous primary or multifocal, second primary after pneumonectomy, proximal to or involved with mediastinal structures, abutting the chest wall, or recurring after previous treatment. Qualifying statements are included to provide further guidance for implementation, and the importance of a discussion of treatment options among members of the multidisciplinary cancer care team is emphasized. Additional information is available at: Www.asco.org/thoracic-cancer-guidelines and www.asco.org/guidelineswiki.",
author = "Schneider, {Bryan J.} and Daly, {Megan E.} and Kennedy, {Erin B.} and Antonoff, {Mara B.} and Stephen Broderick and Jill Feldman and Shruti Jolly and Bryan Meyers and Gaetano Rocco and Chad Rusthoven and Slotman, {Ben J.} and Sterman, {Daniel H.} and Stiles, {Brendon M.}",
year = "2018",
doi = "10.1200/JCO.2017.74.9671",
language = "English",
volume = "36",
pages = "710--719",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
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Schneider, BJ, Daly, ME, Kennedy, EB, Antonoff, MB, Broderick, S, Feldman, J, Jolly, S, Meyers, B, Rocco, G, Rusthoven, C, Slotman, BJ, Sterman, DH & Stiles, BM 2018, 'Stereotactic body radiotherapy for early-stage non-small-cell lung cancer: American society of clinical oncology endorsement of the American society for radiation oncology evidence-based guideline' Journal of Clinical Oncology, vol. 36, no. 7, pp. 710-719. https://doi.org/10.1200/JCO.2017.74.9671

Stereotactic body radiotherapy for early-stage non-small-cell lung cancer: American society of clinical oncology endorsement of the American society for radiation oncology evidence-based guideline. / Schneider, Bryan J.; Daly, Megan E.; Kennedy, Erin B.; Antonoff, Mara B.; Broderick, Stephen; Feldman, Jill; Jolly, Shruti; Meyers, Bryan; Rocco, Gaetano; Rusthoven, Chad; Slotman, Ben J.; Sterman, Daniel H.; Stiles, Brendon M.

In: Journal of Clinical Oncology, Vol. 36, No. 7, 2018, p. 710-719.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Stereotactic body radiotherapy for early-stage non-small-cell lung cancer: American society of clinical oncology endorsement of the American society for radiation oncology evidence-based guideline

AU - Schneider, Bryan J.

AU - Daly, Megan E.

AU - Kennedy, Erin B.

AU - Antonoff, Mara B.

AU - Broderick, Stephen

AU - Feldman, Jill

AU - Jolly, Shruti

AU - Meyers, Bryan

AU - Rocco, Gaetano

AU - Rusthoven, Chad

AU - Slotman, Ben J.

AU - Sterman, Daniel H.

AU - Stiles, Brendon M.

PY - 2018

Y1 - 2018

N2 - Purpose The American Society for Radiation Oncology (ASTRO) produced an evidence-based guideline on treatment with stereotactic body radiotherapy (SBRT) for patients with early-stage non-small-cell lung cancer. ASCO has a policy and set of procedures for endorsing and/or adapting clinical practice guidelines that have been developed by other professional organizations. Methods The ASTRO Evidence-Based Guideline for Stereotactic Body Radiotherapy for Early-Stage Non- Small-Cell Lung Cancer was reviewed for developmental rigor by methodologists. An ASCO Expert Panel updated the literature search and reviewed the guideline content and recommendations. Results The ASCO Expert Panel determined that the recommendations from the ASTRO guideline, published in 2017, are clear, thorough, and based on the most relevant scientific evidence. ASCO statements and minor modifications were added to enhance the applicability of the ASTRO guideline for the broader ASCO audience. Recommendations For standard operative risk patients with stage I NSCLC, SBRT is not recommended outside of a clinical trial. Lobectomywith systematic lymph node evaluation remains the recommended treatment, although a sublobar resection may be considered in select clinical scenarios. Recommendations are provided regarding the use of SBRT in high operative risk patients and for inoperative patients, including in challenging scenarios where tumors are: centrally located, . 5 cm in diameter, lacking tissue diagnosis, synchronous primary or multifocal, second primary after pneumonectomy, proximal to or involved with mediastinal structures, abutting the chest wall, or recurring after previous treatment. Qualifying statements are included to provide further guidance for implementation, and the importance of a discussion of treatment options among members of the multidisciplinary cancer care team is emphasized. Additional information is available at: Www.asco.org/thoracic-cancer-guidelines and www.asco.org/guidelineswiki.

AB - Purpose The American Society for Radiation Oncology (ASTRO) produced an evidence-based guideline on treatment with stereotactic body radiotherapy (SBRT) for patients with early-stage non-small-cell lung cancer. ASCO has a policy and set of procedures for endorsing and/or adapting clinical practice guidelines that have been developed by other professional organizations. Methods The ASTRO Evidence-Based Guideline for Stereotactic Body Radiotherapy for Early-Stage Non- Small-Cell Lung Cancer was reviewed for developmental rigor by methodologists. An ASCO Expert Panel updated the literature search and reviewed the guideline content and recommendations. Results The ASCO Expert Panel determined that the recommendations from the ASTRO guideline, published in 2017, are clear, thorough, and based on the most relevant scientific evidence. ASCO statements and minor modifications were added to enhance the applicability of the ASTRO guideline for the broader ASCO audience. Recommendations For standard operative risk patients with stage I NSCLC, SBRT is not recommended outside of a clinical trial. Lobectomywith systematic lymph node evaluation remains the recommended treatment, although a sublobar resection may be considered in select clinical scenarios. Recommendations are provided regarding the use of SBRT in high operative risk patients and for inoperative patients, including in challenging scenarios where tumors are: centrally located, . 5 cm in diameter, lacking tissue diagnosis, synchronous primary or multifocal, second primary after pneumonectomy, proximal to or involved with mediastinal structures, abutting the chest wall, or recurring after previous treatment. Qualifying statements are included to provide further guidance for implementation, and the importance of a discussion of treatment options among members of the multidisciplinary cancer care team is emphasized. Additional information is available at: Www.asco.org/thoracic-cancer-guidelines and www.asco.org/guidelineswiki.

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