Estro-Halt EU- Designed for Estrogen Support | Contains CDG, Indole-3-Carbinol & Apigenin

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Opioids are the main analgesics for the treatment of moderate to severe cancer-related pain; the first option is oral morphine [I, A]; but other opioids and alternative routes (transdermic, subcutaneous) can be required in specific situations (ie, intestinal obstruction, problems with swallowing, renal failure) [III, B]. Teleworking is not just an option; it's a standard practice at ESTRO. As an employee, you may take control of your work-life balance by choosing if you want to work from home or from the office, with the added perk of a 4-day workweek under certain conditions. Patients who progressed after first-line platinum-based chemotherapy should be offered treatment with the anti PD-1 agent, cemiplimab, regardless of PDL-1 tumor status as long as they had not previously received immunotherapy [I, A]. The use of whole-body diffusion-weighted imaging MRI (WB-DWI/MRI) can reliably obviate the need for gadolinium contrast and radiation for nodal and distant staging during pregnancy. If not available, chest CT scan with abdominal shielding is an alternative. PET-CT should be avoided during pregnancy [IV, B].

Patients should be carefully counseled on the suggested treatment plan and potential alternatives, including risks and benefits of all options [V, A]. Image-guided radiotherapy with daily on-board 3D imaging is recommended for IMRT/VMAT to ensure safe dose application with limited PTV margins. Concomitant chemotherapy should be based on single-agent radiosensitizing chemotherapy, preferably cisplatin (weekly 40 mg/m 2). If cisplatin is not applicable, alternative treatment options are weekly carboplatin (area under the curve (AUC) =2) or hyperthermia (if available). EBRT may also be applied without concomitant chemotherapy or hyperthermia according to patient selection (ie, patients unfit for any chemotherapy). Brachytherapy

Ane Appelt (UK), Catharine Clark (UK), Christian Richter (DE), David Sarrut (FR), Dirk Verellen (BE), Eduard Gershkevitsh (EE), Kathrine Røe Redalen (NO), Livia Marrazzo (IT), Lorenzo Placidi (IT), Marianne Aznar (DK), Nuria Jornet (ES), Tiina Seppälä (FI), Uulke van der Heide (NL), Victor Hernandez (ES), Wolfgang Birkfellner (AT), Ye Zhang (CH) Quantum Estro Support offers natural estrogen support for women and men.* This top-tier formula contains DIM ( diinydolylmethane ), which helps promote cell cycle activity and healthy estrogen metabolism.* This formula is anchored with comprehensive botanical support in two unique blends: Fem Phyto- Support TM and Estro ProBlend TM for optimal nutritional effect. * Quantum Estro Support is a top choice nutritional formula and is highly recommended as a valuable everyday hormone support supplement.* Quantum Quality Guarantee

Definitive management (ie, without tumor related surgery) consists of EBRT with concomitant platinum-based chemotherapy and BT. Delay of treatment and/or treatment interruptions have to be prevented to avoid tumor progression and accelerated repopulation. The overall treatment time including both EBRT and BT should therefore not exceed 7 weeks. Definitive CTRT and BT CTRT If you also combine following criteria and qualities, then you are probably the person we are looking for: Suggested Use: Infuse 2 teaspoons in an 8oz serving of spring water. Boil water, then steep the blend for 15 minutes before serving. The addition of bevacizumab to platinum-based chemotherapy is recommended when the risk of significant gastrointestinal/genitourinary toxicities has been carefully assessed and discussed with the patient [I, A].Adjuvant radiotherapy should be considered in the intermediate risk group (combination of risk factors at final pathology such as tumor size, LVSI, and depth of stromal invasion) [IV, A].

Medical management of malignant intestinal obstruction consists of antisecretory, corticosteroids, and antiemetic drugs. A nasogastric tube is recommended if vomiting and discomfort persist in spite of medical management. Surgical procedures can be considered in selected patients [IV, B]. Definitive CTRT combined with IGABT is the treatment of choice in radiotherapy naïve patients [IV, A]. The use of boost by external beam techniques to replace IGBT is not recommended [IV, D]. The addition of pembrolizumab to platinum-based chemotherapy±bevacizumab is recommended in patients with PD-L1 positive tumors, assessed as combined positive score (CPS) of 1 or more [I, A]. The ambition of ESTRO to further reinforce radiation oncology as a core partner in multidisciplinary cancer care, and to guarantee accessible and high-value radiation therapy for all cancer patients who need it, is expressed in the society’s vision statement for 2030: ‘Radiation Oncology. Optimal Health for All, Together.’After SLN biopsy, if SLN are negative on frozen section, a systematic pelvic lymphadenectomy should be performed as the standard LN staging [III, A].