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Publications

Journal Article Epublish

PubMed: 42830810 DOI: 10.1016/j.phro.2026.101075

ESTRO consensus recommendations on total skin electron beam technique - Endorsed by ILROG.

Phys Imaging Radiat Oncol 41:101075

Authors: Christos Moustakis, Isak Hannes Wahlstedt, Kalliopi-Pola Platoni, Tze Yee Lim, María Aurora Vicedo González, Trinitat García Hernández, Mario Levis, Gabriele Simontacchi, Belinda A Campbell, Stefanie Corradini, Stephen Morris, George Patatoukas, Youlia Kirova, Bouthaina Dabaja, Hans Theodor Eich, Sabbah I Hammoury, Andrea Baehr, Livia Marrazzo, Laila König, Mohamed A Schumann, Lena Specht, Richard Cowan, Khaled Elsayad

Affiliations

  • Division of Medical Physics, Department of Radiation Oncology, Leipzig University Hospital, Leipzig, Germany.
  • Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Denmark.
  • Department of Radiation Oncology, Attikon University Hospital, National and Kapodistrian University of Athens, Greece.
  • Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA.
  • Department of Radiation Oncology, Hospital General Universitario de Valencia, Spain.
  • Department of Oncology, University of Turin, Turin, Italy.
  • Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
  • Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
  • Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia.
  • Department of Clinical Pathology, University of Melbourne, Parkville, Australia.
  • Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
  • Department of Radiation Oncology, Guy's & St Thomas' NHS Foundation Trust in London, UK.
  • Department of Radiation Oncology, Institut Curie, Paris, France.
  • Department of Radiation Oncology, Münster University Hospital, Münster, Germany.
  • Department of Physics and Radiotherapy, Ayadi 4040 Hospital, Alexandria, Egypt.
  • Department of Radiation Oncology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
  • University of Florence, Florence, Italy.
  • Medical Physics Unit, Oncology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
  • Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
  • Department of Radiation Oncology, University Hospital LMU, Munich, Germany.
  • Bavarian Cancer Research Center (BZKF), Munich, Germany.
  • Department of Clinical Oncology, Christie Hospital, University of Manchester, Manchester, UK.
  • Department of Radiation Oncology, UKGM Marburg, Marburg, Germany.
  • University Marburg, Marburg, Germany.
  • Marburg Ion-Beam Therapy Center (MIT), Department of Radiation Oncology, UKGM Marburg, Marburg, Germany.
  • University Cancer Center (UCT) Frankfurt-Marburg, Marburg, Germany.
  • Department of Radiation Oncology, University Hospital Bonn, Bonn, Germany.

Abstract

BACKGROUND AND PURPOSE

Total skin electron beam therapy (TSEBT) is an established radiation treatment modality for the management of cutaneous T-cell lymphoma (CTCL). In recent years, there has been an increasing interest in dose de-escalation strategies aimed at lowering treatment-induced side effects whilst maintaining efficacy. This evolution in clinical practice has highlighted the need for consistent technical standards to ensure treatment quality and comparability across medical institutions. A unified set of recommendations for TSEBT in the modern era was sought by the European Society for Radiotherapy and Oncology (ESTRO) Guidelines Sub-Group on Physics, including physical requirements, with the aim of harmonizing clinical practice, promoting homogeneity for clinical trials, and facilitating wider adoption of the technique.

MATERIAL AND METHODS

The ESTRO Guidelines Committee developed these recommendations using a Delphi consensus methodology. An expert panel consisting of radiation oncologists and medical physicists with specific expertise in the radiation treatment of primary cutaneous lymphoma was convened. Panel members completed a 14-question survey focusing on key technical aspects of TSEBT.

RESULTS

Consensus was achieved on the principal physical and technical components of TSEBT delivery, including prescribed dose levels, field dimensions, treatment techniques, and QA requirements. Areas of agreement reflect current best practices and address sources of variability that may impact treatment reproducibility.

CONCLUSIONS

ESTRO recommendations provide a standardised framework for the delivery of TSEBT in the management of CTCL, supporting safe implementation and consistency across medical institutions in the context of reduced-dose treatment approaches.

MeSH

Radiotherapy, Skin, Lymphoma, Therapeutics