Practice Guidelines for Radiotherapy of Non-Malignant Disorders: A Multicenter 3 Approach in Germany – Development, Introduction and General Comments

Purpose: To develop consensus guidelines for radiotherapy (RT) of benign diseases by the implementation of an S2e clinical practice guideline. Methods: The process started with the formation of a scientific panel. The development process of these clinical guidelines followed the national and international standards: They are based on a consensus process as well as an evidencebased methodology, so that an S2e clinical guideline resulted. The following diseases and topics were covered by the guideline: Physical and radiobiological background, radiogenic risks, lymph fistulas, bursitis trochanterica, Gorham-Stout syndrome, vertebral hemangiomas, pigmented villonodular synovitis (PVNS), heterotopic ossifications, osteoarthritis of large and small joints, Morbus Dupuytren, Morbus Ledderhose, desmoid tumors (aggressive fibromatosis), plantar fasciitis (painful heel spurs), Peyronie's disease, painful elbow syndrome and shoulder syndrome, keloids and endocrine orbitopathy. Results: These clinical guidelines consist of the following components: (1) the physical and radiobiological basis for RT, (2) considerations regarding risks of low radiation doses, (3) general indications for the application of RT and (4) special treatment concepts for benign conditions except benign brain tumors. Conclusions: Written evidence-based consensus guidelines have been updated in 2014 and brought into a publication consisting of four parts. These guidelines may serve as a starting point for continuous quality assessment, future clinical research including the design of prospective clinical trials, and outcome research in this important field of radiotherapy.