Multicentre treatment planning inter-comparison in a national context: The liver stereotactic ablative radiotherapy case

Esposito, Marco; Maggi, G; Marino, C.; Bottalico, Laura; Cagni, E.; Carbonini, C.; Casale, M.; Clemente, Stefania; D'Alesio, V.; Fedele, David A.; Giglioli, F.R.; Landoni, V.; Martinotti, A.S.; Nigro, R.; Strigari, Lidia; Villaggi, E.; Mancosu, P.

doi:10.1016/j.ejmp.2015.09.009

Cited by 56 publications

(22 citation statements)

References 22 publications

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“…Other multi-center SBRT planning studies have typically involved the re-planning of a set of case plans for an individual clinical site with different treatment modalities; spine [24,25], liver [26] and lung [27]. Reporting the variability of plan quality over a small selection of plans is valuable to verify local plan quality, however, most planning studies in the literature do not correlate the variation of results with patient specific variables, such as PTV size, and so are unable to propose any general planning guidance on what may be practically achievable.…”

Section: Introductionmentioning

confidence: 99%

Multi-center evaluation of dose conformity in stereotactic body radiotherapy

Lee

Dean

Patel

et al. 2019

Physics and Imaging in Radiation Oncology

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Background and purpose: Stereotactic body radiotherapy (SBRT) is an emerging technique for treating oligometastases, but limited data is available on what plan quality is achievable for a range of modalities and clinical sites. Methods: SBRT plans for lung, spine, bone, adrenal, liver and node sites from 17 participating centers were reviewed. Centers used various delivery techniques including static and rotational intensity-modulation and multiple non-coplanar beams. Plans were split into lung and other body sites and evaluated with different plan quality metrics, including two which are independent of target coverage; "prescription dose spillage" (PDS) and "modified gradient index" (MGI). These were compared to constraints from the ROSEL and RTOG 0813 clinical trials. Results: Planning target volume (PTV) coverage was compromised (PTV V100% < 90%) in 29% of patient plans in order to meet organ-at-risk (OAR) tolerances, supporting the use of plan quality metrics which are independent of target coverage. Both lung (n = 48) and other body (n = 99) site PDS values agreed well with ROSEL constraints on dose spillage, but RTOG 0813 values were too high to detect sub-optimal plans. MGI values for lung plans were mis-matched to both sets of previous constraints, with ROSEL values too high and RTOG 0813 values too low. MGI values were lower for other body plans as expected, though this was only statistically significant for PTV volumes < 20 cm 3. Conclusions: Updated guidance for lung and other body site SBRT plan quality using the PDS and MGI metrics is presented.

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Section: Introductionmentioning

confidence: 99%

Multi-center evaluation of dose conformity in stereotactic body radiotherapy

Lee

Dean

Patel

et al. 2019

Physics and Imaging in Radiation Oncology

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“…Another aspect of treatment plan quality is the simple fact that the hardware alone does not make a good treatment plan, which is always a combination of conformity to the target volume, steep dose gradients in the healthy tissue, and the technical applicability under realistic conditions. Treatment planning techniques (e.g., coplanar vs. non-coplanar techniques including table angle selection [157] and number of fields or beam energy) are strongly method dependent and significantly influence the treatment plan quality [155,156,[163][164][165][166]. While this has been investigated for numerous indications and well-described methods exist to improve treatment planning [167], center or even user credentialing for stereotactic radiotherapy is still lacking in Germany.…”

Section: Discussionmentioning

confidence: 99%

Technological quality requirements for stereotactic radiotherapy

et al. 2020

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This review details and discusses the technological quality requirements to ensure the desired quality for stereotactic radiotherapy using photon external beam radiotherapy as defined by the DEGRO Working Group Radiosurgery and Stereotactic Radiotherapy and the DGMP Working Group for Physics and Technology in Stereotactic Radiotherapy. The covered aspects of this review are 1) imaging for target volume definition, 2) patient positioning and target volume localization, 3) motion management, 4) collimation of the irradiation and beam directions, 5) dose calculation, 6) treatment unit accuracy, and 7) dedicated quality assurance measures. For each part, an expert review for current state-of-the-art techniques and their particular technological quality requirement to reach the necessary accuracy for stereotactic radiotherapy divided into intracranial stereotactic radiosurgery in one single fraction (SRS), intracranial fractionated stereotactic radiotherapy (FSRT), and extracranial stereotactic body radiotherapy (SBRT) is presented. All recommendations and suggestions for all mentioned aspects of stereotactic radiotherapy are formulated and related uncertainties and potential sources of error discussed. Additionally, further research and development needs in terms of insufficient data and unsolved problems for stereotactic radiotherapy are identified, which will serve as The authors D. Schmitt and O. Blanck contributed equally to the manuscript.

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“…Additionally, the constraint doses of the OARs are the major considerations of dose prescriptions to protect normal tissues and fulfill RT planning. In this study, we selected lung, kidneys, stomach, and intestines as the OARs in mice because these organs were used to be set as the OARs to avoid RIDs during HCC RT in the clinic, 29 and mice might also develop stomach, intestine, and kidney damage after liver RT, as reported in previous studies. 23,24 Obviously, current hypofractionation constraints do allow the safe treatment of many patients but may not be optimal for SBRT, especially for doses more than 7 Gy/fraction.…”

Section: Discussionmentioning

confidence: 99%