The role of ESTRO guidelines in achieving consistency and quality in clinical radiation oncology practice

Abstract

<p>The aim of <em>Radiotherapy & Oncology</em> is to publish original research and topics of interest for radiation oncology. This includes publishing guidelines and recommendations from the European SocieTy for Radiation Oncology (ESTRO) groups focusing on e.g., target volume definitions, radiotherapy planning techniques and quality assurance, as well as on educational aspects including core curricula for the different professional groups forming our discipline. Since 2012 many of the clinical and technical guidelines have been under the auspices of the Advisory Committee for Radiation Oncology Practice (ACROP), now called the ESTRO Guidelines Committee (EGC). A search on Web of Science Nov 2nd, 2022, using search words “Radiotherapy and Oncology”, “guideline or recommendation” and “ESTRO” revealed 259 manuscripts, and 59 of these were original guidelines. In total, these 59 ESTRO guidelines published during 1996–2022 had on average 118 citations each (<a href="https://www.thegreenjournal.com/article/S0167-8140(22)04595-9/abstract#f0005">Fig. 1</a>). The top scoring guidelines are from the GEC ESTRO group <a href="https://www.thegreenjournal.com/article/S0167-8140(22)04595-9/abstract#">[1,2]</a> with > 1000 citations. Twenty guidelines have > 100 citations <a href="https://www.thegreenjournal.com/article/S0167-8140(22)04595-9/abstract#">[1–20]</a>. Thirty of the 100 most downloaded papers during 2021 from all papers ever published in <em>Radiotherapy & Oncology</em> were guidelines, and 18 of these were ESTRO guidelines (personal communication, the Elsevier office). The top-10 list of downloads identifies 7 as guidelines and 3 of them from ESTRO <a href="https://www.thegreenjournal.com/article/S0167-8140(22)04595-9/abstract#">[4,21–26]</a>. In addition, there are a number of ESTRO guidelines published in our sister journals and other journals. A basic principle of guideline development within ESTRO has been that wherever possible they should be evidence-based providing an authoritative view on each subject. Perusing the references cited at the end of recent guidelines reveals a substantial contribution from original articles published in <em>Radiotherapy & Oncology.</em> In some instances, and particularly when addressing radiotherapy technique, there may be no high-level evidence, and consensus guidelines are developed. ESTRO has a strong focus on developing, publishing, reading and evaluating guidelines for radiotherapy, and through the process which has evolved within ACROP, including a rigorous process of external peer review, the guidelines are a scientifically sound basis for the benefit of all patients. Importantly, it has been demonstrated that strict adherence to guidelines translates into better prognosis for patients <a href="https://www.thegreenjournal.com/article/S0167-8140(22)04595-9/abstract#">[27,28]</a>. Acknowledging the importance of guidelines, the ESTRO multidisciplinary teaching courses give a strong focus on our guidelines, which are discussed in detail and demonstrated in practical use <a href="https://www.thegreenjournal.com/article/S0167-8140(22)04595-9/abstract#">[29–31]</a>. Overall, ESTRO and the community can be proud of this work as we strive to do better for our patients, translating to better cancer outcome and less late morbidities. <em>Radiotherapy and Oncology</em> values guidelines and is proud that many of them have been published in our journal. We also offer co-publishing of guidelines and archiving important guidelines otherwise not publicly available as supplementary materials to original publications.<br></p>