ESTRO consensus recommendations on total skin electron beam technique - Endorsed by ILROG
In brief
Experts set shared standards for total-skin radiation in cutaneous lymphoma
A 14-question expert survey reached agreement on key technical elements of total skin electron beam therapy, including dose, treatment fields, delivery techniques, and quality checks. The guidance aims to reduce variation between centers and support consistent use, including lower-dose approaches, but it does not establish whether those approaches maintain treatment effectiveness.
- Journal
- Physics and imaging in radiation oncology (Q1)
- Published
- 3 September 2026
- Study design
- Practice guideline / consensus
- Evidence level
- Level 1, High (CEBM 1c)
- Authors
- Christos Moustakis, Isak Hannes Wahlstedt, Kalliopi-Pola Platoni, Tze Yee Lim, María Aurora Vicedo González, Trinitat García Hernández, et al.
- PMID
- 42830810
- DOI
- 10.1016/j.phro.2026.101075
Why clinicians should know about it
- Picked for Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging (paper of the day, 6 October 2026): ESTRO consensus on total skin electron beam technique
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.