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We present a review and analysis of the conservation status and International Union for Conservation of Nature (IUCN) threat categories of all 360 currently recognized species of extant and recently extinct turtles and tortoises (Order Testudines). Our analysis is based on the 2018 IUCN Red List status of 251 listed species, augmented by provisional Red List assessments by the IUCN Tortoise and Freshwater Turtle Specialist Group (TFTSG) of 109 currently unlisted species of tortoises and freshwater turtles, as well as re-assessments of several outdated IUCN Red List assessments. Of all recognized species of turtles and tortoises, this combined analysis indicates that 20.0% are Critically Endangered (CR), 35.3% are Critically Endangered or Endangered (CR+EN), and 51.9% are Threatened (CR+EN+Vulnerable). Adjusting for the potential threat levels of Data Deficient (DD) species indicates that 56.3% of all data-sufficient species are Threatened. We calculated percentages of imperiled species and modified Average Threat Levels (ATL; ranging from Least Concern = 1 to Extinct = 8) for various taxonomic and geographic groupings. Proportionally more species in the subfamily Geoemydinae (Asian members of the family Geoemydidae) are imperiled (74.2% CR+EN, 79.0% Threatened, 3.89 ATL) compared to other taxonomic groupings, but the families Podocnemididae, Testudinidae, and Trionychidae and the superfamily Chelonioidea (marine turtles of the families Cheloniidae and Dermochelyidae) also have high percentages of imperiled species and ATLs (42.9-50.0% CR+EN, 73.8-100.0% Threatened, 3.44-4.06 ATL). The subfamily Rhinoclemmydinae (Neotropical turtles of the family Geoemydidae) and the families Kinosternidae and Pelomedusidae have the lowest percentages of imperiled species and ATLs (0%-7.4% CR+EN, 7.4%-13.3% Threatened, 1.65-1.87 ATL). Turtles from Asia have the highest percentages of imperiled species (75.0% CR+EN, 83.0% Threatened, 3.98 ATL), significantly higher than predicted based on the regional species richness, due to much higher levels of exploitation in that geographic region. The family Testudinidae has the highest ATL (4.06) of all Testudines due to the extinction of several species of giant tortoises from Indian and Pacific Ocean islands since 1500 CE. The family Testudinidae also has an ATL higher than all other larger polytypic families (≥ 5 species) of Reptilia or Amphibia. The order Testudines is, on average, more imperiled than all other larger orders (≥ 20 species) of Reptilia, Amphibia, Mammalia, or Aves, but has percentages of CR+EN and Threatened species and an ATL (2.96) similar to those of Primates and Caudata (salamanders).

Introduction Metastasis-directed radiotherapy is of increasing importance in the multidisciplinary management of oligometastatic non-small cell lung cancer (NSCLC), but outcome patterns for stereotactic body radiotherapy (SBRT) of bone oligometastases (BoM) remain insufficiently defined. We aimed to determine oncological outcomes and prognostic factors of SBRT for BoM of NSCLC. Materials and methods Patients with NSCLC treated with SBRT for < 5 BoM between 2010 and 2024 at 15 European cancer centers were retrospectively analyzed. Outcomes included freedom from local recurrence (FFLR), progression-free survival (PFS), overall survival (OS), and adverse events. Results With a median follow-up of 14 months (IQR: 7–24 months), 85 patients with 111 treated BoM were analyzed. The 2-year FFLR was 87.2% (95%-CI: 73.3%-94.1%). The 1-/2-year PFS for singular BoM was 60.1% (CI: 44.6%-72.5%)/ 39.9% (CI: 24.6%-54.8%), while for 2–3 BoM they amounted to 10.2% (95%-CI: 0.6%-35.8%) and 0%. In multivariable analysis, less favorable outcome for OS and PFS was associated with larger BoM (HR 1.003; p  < 0.01 and HR 1.005, p  < 0.001) and increased number of treated BoM (HR 1.72; p  = 0.03 and HR 1.93; p  < 0.01). Treatment was well tolerated, with fracture rates of 5.4% and no grade 4 and 5 adverse events. Conclusion This multicenter cohort analysis revealed that SBRT of BoM from NSCLC appears to be an effective and well-tolerated treatment. Presence of singular BoM was a favorable prognostic factor. Prospective studies are needed to confirm these findings and to determine the role of SBRT in the multidisciplinary management of oligometastases.