A survey of stereotactic body radiotherapy use in the United States

Abstract

BACKGROUND: Stereotactic body radiotherapy (SBRT) is a technique used to deliver high, ablative doses of radiation in a limited number of fractions to !1 extracranial target(s). To the authors' knowledge, the prevalence of SBRT use among radiation oncologists in the United States is unknown. METHODS: A random sample of 1600 American radiation oncologists was surveyed via e-mail and facsimile (fax) regarding SBRT usage, including year of adoption, motivations, disease sites treated, and common prescriptions used. RESULTS: Of 1373 contactable physicians, 551 responses (40.1%) were received. The percentage of physicians using SBRT was 63.9% (95% confidence interval, 60%-68%), of whom nearly half adopted it in 2008 or later. The most commonly cited reasons for adopting SBRT were to allow the delivery of higher than conventional radiation doses (90.3%) and to allow retreatment (73.9%) in select patients. Academic physicians were more likely to report research as a motivation for SBRT adoption, whereas physicians in private practice were more likely to list competitive reasons. Among SBRT users, the most common disease sites treated were lung (89.3%), spine (67.5%), and liver (54.5%) tumors. Overall, 76.0% of current SBRT users planned to increase their use, whereas 66.5% of nonusers planned to adopt the technology in the future. CONCLUSIONS: SBRT has rapidly become a widely adopted treatment approach among American radiation oncologists. Further research and prospective trials are necessary to assess the benefits and risks of this novel technology.

Stereotactic Ablative Radiotherapy for stage I histologically proven non-small cell lung cancer: An Italian multicenter observational study

“…The lack of robust data on patients with histologicaldiagnosis, together with the heterogeneity in SABR studies design(patients' number, inclusion criteria and treatment techniques),might jeopardize the clinical results achieved so far. The routine use of SABR outside clinical trials has continuously increased overthe last years in most countries: a US survey reported that 57% ofresponding physicians practiced SBRT for lung cancer in 2010 [10],and an Italian survey showed that SABR was used in 41% of depart-ments [11]. Palma et al [12] analyzed the time trend in SABR use inelderly patients in the Netherlands, showing an incessant increasein indications in patients previously either untreated or addressedto palliative RT.…”

Emerging radiotherapy technology in a developing country: A single Brazilian institution assessment of stereotactic body radiotherapy application

“…It is important to notice that the majority of respondents who were using SBRT started between 2007 and 2008 and, to the date of the survey, 63.9% of the analyzed centers were adopting SBRT treatments. 9 A Japanese nationwide survey conducted by the end of 2005 reported that lung cancer, followed by liver (primary and metastatic tumors), was the most common site of SBRT treatment. They reported that the average number of involved radiation oncologists was 1.8 per treatment and that treatment planning was the most consuming time (60 to 120 minutes), followed by quality assurance (QA) (50 to 60 min) and daily treatment delivery (< 60 min).…”

“…6,7 Previous surveys were conducted in the USA and Japan. 8,9 To our knowledge, this article is the first representation of the SBRT profile, its application and temporal trends from a Latin American institution, which can add knowledge to the literature and may be used as a benchmark for future wider analysis.…”

A quantitative assessment of the consequences of allowing dose heterogeneity in prostate radiation therapy planning

“…In this study, we looked specifically at the consequences of limiting the upper dose to the PTV for low‐ and intermediate‐risk prostate cancer VMAT treatment plans. We investigated this site because (a) ablative doses are generally acceptable for prostate radiation therapy,8, 9, 10, 11, 12 which suggests minimal risk of toxicity from overdosing the PTV exclusively (within reason), (b) it is a site suggested by Craft et al.,5 and (c) prostate treatments are extremely common and make up a major fraction of the clinical workload for many clinics. We conducted a treatment planning study with a cohort of 17 anonymized VMAT patients using our clinical protocol for prostate cancer patients and compared optimization with and without an upper dose constraint on the PTV, which would be thought to be the best case scenario in terms of OAR sparing.…”