Recommendations for Post-Operative RadioTherapy After Complete Resection of Thymoma-a French DELPHI Consensus Initiative.

Autor:	Basse C; Institut du Thorax Curie-Montsouris, Institut Curie, Paris, France; Paris Saclay Campus, Versailles Saint Quentin University, Versailles, France., Khalifa J; Department of Radiotherapy, Institut Claudius Rigaud, Institut Universitaire du Cancer de Toulouse Oncopole, Toulouse, France., Thillays F; Department of Radiation Oncology, Institut de Cancérologie de l'Ouest Centre René Gauducheau, Nantes, France., Le Pechoux C; Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France., Maury JM; Department of Thoracic Surgery, Lung and Heart-Lung Transplantation, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France; IVPC UMR754 INRA, Univ Lyon, Université Claude Bernard Lyon 1, EPHE, Lyon, France., Bonte PE; Biostatistics Department, Research Center, Institut Curie, Paris, France., Coutte A; Department of Radiotherapy, Amiens Hospital, Amiens, France., Pourel N; Radiation Department, Institut Sainte Catherine, Avignon, France., Bourbonne V; Department of Radiotherapy, University Hospital of Brest, Brest, France., Pradier O; Department of Radiotherapy, University Hospital of Brest, Brest, France., Belliere A; Department of Radiotherapy, Centre Jean Perrin, Clermont-Ferrand, France., Le Tinier F; Department of Radiotherapy, Centre Oscar Lambret, Lille, France., Deberne M; Department of Radiotherapy, Hospices Civils Lyonnais, Lyon, France., Tanguy R; Department of Radiotherapy, Hospices Civils Lyonnais, Lyon, France., Denis F; Department of Radiotherapy, Centre de Cancérologie de la Sarthe, ELSAN, Le Mans, France., Padovani L; Department of Radiotherapy, Assistance Publique Hôpitaux de Marseille, Marseille, France., Zaccariotto A; Department of Radiotherapy, Assistance Publique Hôpitaux de Marseille, Marseille, France., Molina T; Pathology Department, Necker Enfants Malades Hospital, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France., Chalabreysse L; Department of Pathology, Groupement Hospitalier Est, Bron Cedex Lyon, France., Brioude G; Department of Thoracic Surgery, Disease of the Oesophagus and Lung Transplantations, Hôpital Nord, Aix-Marseille University, Marseille, France., Delatour B; Department of Thoracic and Cardiovascular Surgery, Rennes University Hospital Center, Rennes, France., Faivre JC; Department of Radiotherapy, Institut de Cancérologie de Lorraine, Nancy, France., Cao K; Institut du Thorax Curie-Montsouris, Institut Curie, Paris, France., Giraud P; Paris City University, Department of Radiation Oncology, Hopital Européen Georges Pompidou, Paris, France., Riet FG; Department of Radiotherapy, Centre Hospitalier Privé Saint Grégoire, Rennes, France., Thureau S; Department of Radiotherapy, Centre Henri Becquerel, Rouen, France., Antoni D; Department of Radiotherapy, ICANS, Institut de Cancérologie de Strasbourg, Strasbourg, France., Massabeau C; Department of Radiotherapy, Institut Claudius Rigaud, Toulouse, France., Keller A; Department of Radiotherapy, Institut Claudius Rigaud, Toulouse, France., Bonnet E; Department of Radiotherapy, IMR de Valence, Valence, France., Lerouge D; Department of Radiation Oncology, Centre Baclesse, Caen, France., Martin E; Department of Radiotherapy, Centre Georges-François-Leclerc, Dijon, France., Girard N; Institut du Thorax Curie-Montsouris, Institut Curie, Paris, France; Paris Saclay Campus, Versailles Saint Quentin University, Versailles, France. Electronic address: nicolas.girard2@curie.fr., Botticella A; Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France.
Jazyk:	angličtina
Zdroj:	Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer [J Thorac Oncol] 2024 Jul; Vol. 19 (7), pp. 1095-1107. Date of Electronic Publication: 2024 Apr 10.
DOI:	10.1016/j.jtho.2024.04.003
Abstrakt:	Introduction: Thymomas are rare intrathoracic malignancies that can relapse after surgery. Whether or not Post-Operative RadioTherapy (PORT) should be delivered after surgery remains a major issue. RADIORYTHMIC is an ongoing, multicenter, randomized phase 3 trial addressing this question in patients with completely R0 resected Masaoka-Koga stage IIb/III thymoma. Experts in the field met to develop recommendations for PORT. Methods: A scientific committee from the RYTHMIC network identified key issues regarding the modalities of PORT in completely resected thymoma. A DELPHI method was used to question 24 national experts, with 115 questions regarding the following: (1) imaging techniques, (2) clinical target volume (CTV) and margins, (3) dose constraints to organs at risk, (4) dose and fractionation, and (5) follow-up and records. Consensus was defined when opinions reached more than or equal to 80% agreement. Results: We established the following recommendations: preoperative contrast-enhanced computed tomography (CT) scan is recommended (94% agreement); optimization of radiation delivery includes either a four-dimensional CT-based planning (82% agreement), a breath-holding inspiration breath-hold-based planning, or daily control CT imaging (81% agreement); imaging fusion based on cardiovascular structures of preoperative and planning CT scan is recommended (82% agreement); right coronary and left anterior descending coronary arteries should be delineated as cardiac substructures (88% agreement); rotational RCMI/volumetric modulated arc therapy is recommended (88% agreement); total dose is 50 Gy (81% agreement) with 1.8 to 2 Gy per fraction (94% agreement); cardiac evaluation and follow-up for patients with history of cardiovascular disease are recommended (88% agreement) with electrocardiogram and evaluation of left ventricular ejection fraction at 5 years and 10 years. Conclusion: This is the first consensus for PORT in thymoma. Implementation will help to harmonize practices. Competing Interests: Disclosure The authors have no conflict of interest to disclose concerning the current work. (Copyright © 2024 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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