ESTRO 2026 Congress Report

By the ESTRO CNS Focus Group

 

Neuro-radiation oncology is playing an increasingly visible role among the breadth of scientific advances within radiation oncology that were highlighted at the ESTRO annual meeting. The congress provided a platform for discussions of many topics that reflect the continued development of this subspecialty, including clinical research, imaging innovation and evolving treatment concepts.

Clemens Seidel (Germany) presented data comparing different whole-brain radiotherapy (WBRT) doses in primary central nervous system (CNS) lymphoma. The results showed no survival differences between higher and lower dose regimens and thereby supported the use of WBRT doses below 30Gy. In the field of advanced imaging, Suman Ghosh (Canada) demonstrated the potential of amide-proton-transfer-weighted MRI to improve visualisation of tumour infiltration, thereby reducing uncertainty in target delineation and allowing for smaller clinical target volume margins.

Regarding treatment of paediatric malignant brainstem glioma, Yuan-yuan Chen (China) reported encouraging safety and efficacy data for the combination of anlotinib and radiotherapy. Julian Philipp Layer (Germany) presented a strategy of dual inhibition of angiogenesis and vasculogenesis through blockade of vascular endothelial growth factor and the C-X-C motif chemokine ligand 12. These findings suggest a safe and promising approach to newly diagnosed glioblastoma.

A key highlight was the presentation of the final results of the open-label, multicentre, randomised phase III trial of the use of intraoperative radiotherapy in newly diagnosed glioblastoma (INTRAGO-II) by Frank Giordano (Germany). The study investigated the application of intraoperative radiotherapy with a 30Gy boost to the applicator surface in addition to standard radiochemotherapy for this condition. Although the dose escalation brought no overall survival benefit, the trial represents an important contribution to prospective clinical evidence in the field. Congratulations to the investigators on the publication of these results in The Lancet Oncology.

The joint ESTRO–European Association of Neuro-oncology debate, hosted by Giuseppe Minniti (Italy) and Nicolaus Andratschke (Switzerland), addressed the timing of local treatment for brain metastases in the era of targeted and immune therapies. The discussion emphasised that the optimal sequencing of local and systemic approaches remained unresolved and highlighted the need for prospective clinical data.

Beyond the scientific sessions, the highly-attended CNS meet-and-greet, which was organised by the ESTRO CNS focus group, again demonstrated the growing international interest in neuro-radiation oncology. The lively discussions highlighted both the momentum of the community and the continued need for dedicated opportunities for exchange within ESTRO.

Overall, the congress reflected the ongoing development of neuro-radiation oncology within radiation oncology, combining clinical research, technical innovation and international collaboration in a rapidly evolving field.

PD Dr med Raphael Bodensohn

Department of Radiation Oncology,

University Hospital Tübingen,

Germany

Raphael.Bodensohn@med.uni-tuebingen.de

ESTRO CNS focus group core member