Guidelines for safe practice of stereotactic body (ablative) radiation therapy

Foote, Matthew; Bailey, Michael; Smith, Leigh; Hegi‐Johnson, Fiona; Seeley, Anna; Barry, Tamara; Booth, Jeremy; Ball, David; Thwaites, David

doi:10.1111/1754-9485.12336

Cited by 40 publications

(50 citation statements)

References 13 publications

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“…A multidisciplinary group editorial proposed an APRT role in paediatric radiotherapy treatment, advocating for specialist RTs in the care of children undergoing radiation therapy. A practice guideline authored by a multidisciplinary group advocating for an APRT role in stereotactic ablative body radiation therapy to “be responsible for management of RT responsibilities within the SABR program” also met the inclusion criteria.…”

Section: Resultsmentioning

confidence: 99%

Advanced practice radiation therapists: an Australian context

Hilder

Dam

Doherty

2018

J of Medical Radiation Sci

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The purpose of this scoping review is to examine the literature regarding the development, implementation, scope and extent of Advanced Practice Radiation Therapist (APRT) roles in Australia in peer reviewed journals, government reports, conference proceedings and reports. A search was undertaken of PubMed, Web of Science and CINAHL, the ASMIRT website and, and Google Scholar to identify relevant documents. Combinations of keywords with Boolean operators ((advanced practice) OR (advanced practitioner) OR (specialist)) AND ((radiation therapist) OR (radiation therapy)) were used. Online and physical searches were conducted between July 16 and 23 2017. Results were not date limited. The searches retrieved 352 after duplicates were removed with 46 remaining after filtering for eligibility criteria. Items consisted of journal articles, conference abstracts, presentation slides, online presentations, State government and ASMIRT reports. A number of potential and existing APRT roles were found in the identified articles, including image review, stereotactic, treatment review, breast localisation, palliative radiotherapy, brachytherapy, radiation engineering and urology. Despite reports indicating that radiation therapists in Australia have been concerned with professional directions since 2001, there is little evidence of formal progress towards defined APRT roles. Several centres have implemented roles in a number of practice areas. The success of APRT roles lies in the ability to demonstrate that implementation goals have been achieved and that patient care has improved. The literature suggests that this is occurring, however, the presented evidence is not compelling.

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Section: Resultsmentioning

confidence: 99%

Advanced practice radiation therapists: an Australian context

Hilder

Dam

Doherty

2018

J of Medical Radiation Sci

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“…[22405060] In addition, there is multinational expert agreement that spine-specific SBRT credentialing is needed for all involved staff. An in-house supervision program whereby staff are supervised for an initial quota of patients is commonly utilized for credentialing.…”

Section: Quality Assurancementioning

confidence: 99%

Stereotactic spine radiosurgery: Review of safety and efficacy with respect to dose and fractionation

Huo¹,

Sahgal²,

Pryor³

et al. 2017

Surg Neurol Int

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Background:Stereotactic body radiotherapy (SBRT) is an emerging treatment option for spinal metastases with demonstrated efficacy in the upfront, postoperative, and re-treatment settings, as well as for tumor histologies considered radioresistant. Uncertainty exists regarding the optimal dose and fractionation schedule, with single and multifraction regimens commonly utilized.Methods:A literature search of the PubMed and Medline databases was conducted to identify papers specific to spine SBRT and the effect of varying dose/fractionation regimens on outcomes. Bibliographies of relevant papers were searched for further references, and international spine SBRT experts were consulted.Results:Local control rates generally exceed 80% at 1 year, while high rates of pain control have been attained. There is insufficient evidence to suggest superiority of either single or multiple fraction regimens with respect to local control and pain control. Low rates of toxicity have been reported, assuming strict dose constraints are respected. Radiation myelopathy may be the most morbid toxicity, although the rates are low. The risk of vertebral compression fracture appears to be associated with higher doses per fraction such as those used in single-fraction regimens. The Spinal Instability Neoplastic Score should be considered when evaluating patients for spine SBRT, and prophylactic stabilisation may be warranted. Pain flare is a relatively common toxicity which may be mediated with prophylactic dexamethasone. Because of the treatment complexity and potentially serious toxicities, strict quality assurance should occur at the organizational, planning, dosimetric, and treatment delivery levels.Conclusion:Both single and multifraction regimens are safe and efficacious in spine SBRT for spinal metastases. There may be advantages to hypofractionated treatment over single-fraction regimens with respect to toxicity. Ongoing investigation is underway to define optimal dose and fractionation schedules.

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“…Although several guidelines or consensus surveys of SABR have been reported [44][45][46][47], there has been no clear and precise definition of SABR. The precise and accurate ablative radiation dose delivery of a relatively large single dose with less than five fractions is generally accepted as SABR [39].…”

Section: Techniques Of Ebrtmentioning

confidence: 99%

Consensus for Radiotherapy in Hepatocellular Carcinoma from The 5th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2014): Current Practice and Future Clinical Trials

Park

Cheng

et al. 2016

Liver Cancer

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A consensus meeting to develop practice guidelines and to recommend future clinical trials for radiation therapy (RT), including external beam RT (EBRT), and selective internal RT (SIRT) in hepatocellular carcinoma (HCC) was held at the 5th annual meeting of the Asia-Pacific Primary Liver Cancer Expert consortium. Although there is no randomized phase III trial evidence, the efficacy and safety of RT in HCC has been shown by prospective and retrospective studies using modern RT techniques. Based on these results, the committee came to a consensus on the utility and efficacy of RT in the management of HCC according to each disease stage as follows: in early and intermediate stage HCC, if standard treatment is not compatible, RT, including EBRT and SIRT can be considered. In locally advanced stage HCC, combined EBRT with transarterial chemoembolization or hepatic arterial infusion chemotherapy, and SIRT can be considered. In terminal stage HCC, EBRT can be considered for palliation of symptoms and reduction of morbidity caused by the primary tumor or its metastases. Despite the currently reported benefits of RT in HCC, the committee agreed that there is a compelling need for large prospective studies, including randomized phase III trial evidence evaluating the role of RT. Specifically studies evaluating the efficacy and safety of sequential combination of EBRT and SIRT are strongly recommended.

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Guidelines for safe practice of stereotactic body (ablative) radiation therapy

Cited by 40 publications

References 13 publications

Advanced practice radiation therapists: an Australian context

Advanced practice radiation therapists: an Australian context

Stereotactic spine radiosurgery: Review of safety and efficacy with respect to dose and fractionation

Consensus for Radiotherapy in Hepatocellular Carcinoma from The 5th Asia-Pacific Primary Liver Cancer Expert Meeting (APPLE 2014): Current Practice and Future Clinical Trials

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