Accreditation and quality assurance for Radiation Therapy Oncology Group: Multicenter clinical trials using Stereotactic Body Radiation Therapy in lung cancer

Timmerman, Robert; Galvin, James M.; Michalski, Jeff M.; Straube, William L.; Ibbott, Geoffrey S.; Martin, Elizabeth; Abdulrahman, Ramzi; Swann, S.; Fowler, Jack; Choy, Hak

doi:10.1080/02841860600902213

Cited by 114 publications

(73 citation statements)

References 19 publications

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“…Usually, the PTV margin is larger in the cranio-caudal direction in SBRT, considering that the tumor motion is larger in the cranio-caudal direction than in the lateral and antero-posterior directions (8,21,22). However, no increase in the PTV margin for the cranio-caudal direction was used in this study considering that RTRT can reduce the size of the margin for respiratory movement.…”

Section: Radiotherapymentioning

confidence: 91%

Steep Dose–Response Relationship for Stage I Non–Small-Cell Lung Cancer Using Hypofractionated High-Dose Irradiation by Real-Time Tumor-Tracking Radiotherapy

Onimaru¹,

Fujino²,

Yamazaki³

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

137

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Section: Radiotherapymentioning

confidence: 91%

Steep Dose–Response Relationship for Stage I Non–Small-Cell Lung Cancer Using Hypofractionated High-Dose Irradiation by Real-Time Tumor-Tracking Radiotherapy

Onimaru¹,

Fujino²,

Yamazaki³

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

137

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“…Patients were treated with SBRT in Novalis (BrainLAB, Feldkirchen, Germany) platform for a total dose of 60 Gy in three fractions ( 14 ) or 30 Gy in a single fraction (www.ClinicalTrials.gov identifier: NCT00843726, a phase III trial led by Roswell Park Cancer Institute, Buffalo, NY). Treatment plans were designed using dynamic conformal arcs with 6 MV photon beams in iPlan RT 4.1.2 TPS following the protocol guidelines.…”

Section: Methodsmentioning

confidence: 99%

“…( 7 ) Currently, dose calculation algorithms with heterogeneity correction are not consistent among different treatment planning systems, ( 8 – 12 ) depending on how the changes in lateral electron transport are taken into account. ( 13 ) For this reason, dose calculations without heterogeneity correction were required in RTOG 0236, ( 14 ) which was a phase II trial of SBRT in the early stages of medically inoperable NSCLC. This requirement is supported by the consistent performance of dose calculation algorithms in different treatment planning systems for homogeneous water.…”

Section: Introductionmentioning

confidence: 99%

Dose calculation differences between Monte Carlo and pencil beam depend on the tumor locations and volumes for lung stereotactic body radiation therapy

Zhuang

Djemil

Pan

et al. 2013

J Applied Clin Med Phys

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Stereotactic body radiation therapy (SBRT) has been increasingly used as an efficacious treatment modality for early‐stage non‐small cell lung cancer. The accuracy of dose calculations is compromised due to the presence of inhomogeneity. For the purpose of a consistent prescription, radiation doses were calculated without heterogeneity correction in several RTOG trials. For patients participating in these trials, recalculations of the planned doses with more accurate dose methods could provide better correlations between the treatment outcomes and the planned doses. Using a Monte Carlo (MC) dose calculation algorithm as a gold standard, we compared the recalculated doses with the MC algorithm to the original pencil beam (PB) calculations for our institutional clinical lung SBRT plans. The focus of this comparison is to investigate the volume and location dependence on the differences between the two dose calculations. Thirty‐one clinical plans that followed RTOG and other protocol guidelines were retrospectively investigated in this study. Dosimetric parameters, such as D1, D95, and D99 for the PTV and D1 for organs at risk, were compared between two calculations. Correlations of mean lung dose and V20 of lungs between two calculations were investigated. Significant dependence on tumor size and location was observed from the comparisons between the two dose calculation methods. When comparing the PB calculations without heterogeneity correction to the MC calculations with heterogeneity correction, we found that in terms of D95 of PTV: (1) the two calculations resulted in similar D95 for edge tumors with volumes greater than 25.1 cc; (2) an average overestimation of 5% in PB calculations for edge tumors with volumes less than 25.1 cc; and (3) an average overestimation of 9% or underestimation of 3% in PB calculations for island tumors with volumes smaller or greater than 22.6 cc, respectively. With heterogeneity correction, the PB calculations resulted in an average reduction of 23.8% and 15.3% in the D95 for the PTV for island and edge lesions, respectively, when compared to the MC calculations. For organs at risks, very small differences were found among all the comparisons. Excellent correlations for mean dose and V20 of lungs were observed between the two calculations. This study demonstrated that using a single scaling factor may be overly simplified when accounting for the effects of heterogeneity correction. Accurate dose calculations, such as the Monte Carlo algorithms, are highly recommended to understand dose responses in lung SBRT.PACS number: 87.53.Ly

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“…The first such work began in 2002 when the Radiation Therapy Oncology Group in North America began the process of developing multicenter prospective trials in lung cancer using SBRT [31]. These activities have had an impact not only on the treatment received by patients enrolled in clinical trials, but also on the quality of treatment administered to all patients treated in each institution.…”

Section: Discussionmentioning

confidence: 99%

“…Many of these guidelines have been set forth by national and international professional organizations. However, the majority of such work in QA for radiosurgery has focused on the successful implementation of QA in the context of multi-centered clinical trials [25,[28][29][30][31]. Others have published practice guidelines endorsed by governing organizations for the performance of SBRT to serve as an educational tool designed to assist practitioners in providing appropriate care for patients [32].…”

Section: Introductionmentioning

confidence: 99%

A Multinational Report on Methods for Institutional Credentialing for Spine Radiosurgery

Gerszten

Kersh

Sweeney

et al. 2012

International Journal of Radiation Oncology*Biology*Physics

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Background: Stereotactic body radiotherapy and radiosurgery are rapidly emerging treatment options for both malignant and benign spine tumors. Proper institutional credentialing by physicians and medical physicists as well as other personnel is important for the safe and effective adoption of spine radiosurgery. This article describes the methods for institutional credentialing for spine radiosurgery at seven highly experienced international institutions. Methods: All institutions (n = 7) are members of the Elekta Spine Radiosurgery Research Consortium and have a dedicated research and clinical focus on image-guided spine radiosurgery. A questionnaire consisting of 24 items covering various aspects of institutional credentialing for spine radiosurgery was completed by all seven institutions.

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Accreditation and quality assurance for Radiation Therapy Oncology Group: Multicenter clinical trials using Stereotactic Body Radiation Therapy in lung cancer

Cited by 114 publications

References 19 publications

Steep Dose–Response Relationship for Stage I Non–Small-Cell Lung Cancer Using Hypofractionated High-Dose Irradiation by Real-Time Tumor-Tracking Radiotherapy

Steep Dose–Response Relationship for Stage I Non–Small-Cell Lung Cancer Using Hypofractionated High-Dose Irradiation by Real-Time Tumor-Tracking Radiotherapy

Dose calculation differences between Monte Carlo and pencil beam depend on the tumor locations and volumes for lung stereotactic body radiation therapy

A Multinational Report on Methods for Institutional Credentialing for Spine Radiosurgery

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