PURPOSE: Treatment-related toxicity after irradiation of brain tumours has been underreported in the literature. Furthermore, there is considerable heterogeneity on how and when toxicity is evaluated. The aim of this European Particle Network (EPTN) collaborative project is to develop recommendations for uniform follow-up and toxicity scoring of adult brain tumour patients treated with radiotherapy. METHODS: A Delphi method-based consensus was reached among 24 international radiation-oncology experts in the field of neuro-oncology concerning the toxicity endpoints, evaluation methods and time points. RESULTS: In this paper, we present a basic framework for consistent toxicity scoring and follow-up, using multiple levels of recommendation. Level I includes all recommendations that are considered minimum of care, whereas level II and III are optional evaluations in the advanced clinical or research setting, respectively. Per outcome domain, the clinical endpoints and evaluation methods per level are listed. Where relevant, the organ at risk threshold doses for recommended referral to specific organ specialists are defined. CONCLUSION: These consensus-based recommendations for follow-up will enable the collection of uniform toxicity data of brain tumour patients treated with radiotherapy. With adoptation of this standard, collaboration will be facilitated and we can further propel the research field of radiation-induced toxicities relevant for these patients. An online tool to implement this guideline in clinical practice is provided at www.cancerdata.org.

Clinic for Particle Therapy University Hospital Essen West German Cancer Center partnersite Essen Germany

Danish Centre for Particle Therapy Aarhus Denmark; Norwegian Radiation and Nuclear Safety Authority Oslo Norway

Department of Oncology Sahlgrenska University Hospital Gothenburg Sweden

Department of Radiation Oncology Cliniques universitaires Saint Luc Brussels Belgium; Particle Therapy Interuniversitary Center Leuven Belgium

Department of Radiation Oncology Eberhard Karls Universität Tübingen Germany

Department of Radiation Oncology GROW School for Oncology Maastricht University Medical Centre The Netherlands

Department of Radiation Oncology University Medical Center Groningen University of Groningen The Netherlands

German Cancer Consortium Partner Site Dresden Germany

Heidelberg Ion Beam Therapy Centre Department of Radiation Oncology University Hospital Heidelberg Heidelberg Germany

Holland Proton Therapy Centre Delft The Netherlands

Holland Proton Therapy Centre Delft The Netherlands; Department of Radiotherapy Erasmus MC Cancer Institute Rotterdam The Netherlands

Holland Proton Therapy Centre Delft The Netherlands; Haaglanden Medisch Centrum Department of Radiotherapy Leidschendam The Netherlands

Institut Curie Radiation Oncology Department Paris and Proton Center Orsay France

Institute Curie Paris France; Institute Curie Centre de Protonthérapie d'Orsay Orsay France

KU Leuven University of Leuven Department of Oncology Laboratory of Experimental Radiotherapy Belgium; University Hospitals Leuven Department of Radiation Oncology Belgium

KU Leuven University of Leuven Department of Oncology Laboratory of Experimental Radiotherapy Belgium; University Hospitals Leuven Department of Radiation Oncology Belgium; Particle Therapy Interuniversitary Center Leuven UZ Leuven Gasthuisberg Belgium

Leiden University Medical Centre Department of Radiotherapy The Netherlands; Holland Proton Therapy Centre Delft The Netherlands

National Center for Oncological Hadrontherapy Pavia Italy

Paul Scherrer Institut Center for Proton Therapy ETH Domain Villigen Switzerland

Proton Therapy Center Czech Prague Czech Republic

The Christie NHS Foundation Trust Manchester United Kingdom

The University of Manchester Manchester Academic Health Science Centre The Christie NHS Foundation Trust United Kingdom; The Children's Brain Tumour Research Network University of Manchester Royal Manchester Children's Hospital United Kingdom

References provided by Crossref.org