ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2024
Appropriate Use Criteria (AUC) for the Management of Non-Small Cell Lung Cancer in a Central/Ultra-Central Location: Guidelines from the American Radium Society.
Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Stereotactic body radiation therapy for ultra-central lung malignancies: an updated systematic review and meta-analysis.Radiation oncology (London, England) · 2026Pooled it
- Article
- Outcome and safety of SBRT in centrally and ultra-centrally located lung tumours: A PRISMA-based systematic review and Meta-Analysis.Clinical and translational radiation oncology · 2026Article
- Chemoimmunotherapy improves surgical resection rate and survival versus chemotherapy in potentially resectable non-small cell lung cancer: a real-world propensity score-matched study.Journal of thoracic disease · 2026Article
- Value of [European journal of nuclear medicine and molecular imaging · 2026Article
- Impact of tumour proximity to organs-at-risk in adaptive MR-guided SBRT for central lung tumours and metastases.Clinical and translational radiation oncology · 2026Article
- Oxygenation: Nanotechnological Strategies for Conquering Tumor Hypoxia in Photodynamic Therapy.International journal of nanomedicine · 2026Review
- Application of respiratory motion management technology for patients with lung cancer treated with stereotactic body radiotherapy (Review).Oncology letters · 2025Review
- Prescription dose and optimisation strategies in MR-guided online adaptive radiotherapy for kidney tumours: a two-step planning analysis.Radiation oncology (London, England) · 2025Article
- Stereotactic ablative body radiation therapy for treatment of ultra-central lung tumors: a narrative review.Journal of thoracic disease · 2025Review
- How to protect the proximal bronchial tree during stereotactic radiotherapy of ultracentral lung tumors: Lessons from MR-guided treatment.Clinical and translational radiation oncology · 2025Article
- Exploring the Current Challenges and Pioneering Clinical Applications of Stereotactic Radiotherapy in Cancer Treatment.Technology in cancer research & treatmentArticle
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Authors and funding
17 authors.
Funding
Abstract
introductionDefinitive radiation therapy is considered standard therapy for medically inoperable early-stage NSCLC. Nevertheless, for patients with tumors located near structures such as the proximal tracheobronchial tree, esophagus, heart, spinal cord, and brachial plexus, the optimal management regimen is controversial. The objective was to develop expert multidisciplinary consensus guidelines on managing medically inoperable NSCLC located in a central or ultracentral location relative to critical organs at risk.
methodsCase variants regarding centrally and ultracentrally located lung tumors were developed by the 15-member multidisciplinary American Radium Society (ARS) Thoracic Appropriate Use Criteria (AUC) expert panel. A comprehensive review of the English medical literature was performed from January 1 1946 to December 31 2023 to inform consensus guidelines. Modified Delphi methods were used by the panel to evaluate the variants and procedures, with at least three rating points from median defining agreement/consensus. The guideline was then approved by the ARS Executive Committee and released for public comment per established ARS procedures.
resultsThe Thoracic ARS AUC Panel identified 90 relevant references and obtained consensus in all variants. Radiotherapy alone was considered appropriate, with additional immunotherapy to be considered primarily in the clinical trial setting. Hypofractionated radiotherapy in eight to 18 fractions was considered appropriate for ultracentral lesions near the proximal tracheobronchial tree, upper trachea, and esophagus. For other ultracentral lesions near the heart, great vessels, brachial plexus, and spine, or for non-ultracentral but still central lesions, five-fraction stereotactic body radiation therapy was also considered an appropriate option. Intensity-modulated radiotherapy was considered appropriate and three-dimensional-conformal radiotherapy inappropriate for all variants. Other treatment planning techniques to decrease the risk of overdosing critical organs at risk were also considered.
conclusionsThe ARS Thoracic AUC panel has developed multidisciplinary consensus guidelines for various presentations of stage I NSCLC in a central or ultracentral location.
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