Developments in Stereotactic Body Radiotherapy

Haridass, A.

doi:10.3390/cancers10120497

Cited by 16 publications

(15 citation statements)

References 75 publications

(52 reference statements)

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“…High dose per fraction and short course of treatment can be achieved when the accuracy of irradiation is granted, while geometrically sparing the innocent normal tissues ( 20 ). High-dose radiation to small volume targets in a single or small number of fractionations could be precisely projected by stereotactic focus under image guidance ( 32 , 33 ). SABR was delivered with high dose per fraction in a relatively short course (SBRT delivers 40–60 Gy in 1–5 fractions and SRS irradiates lesions with 18–25 Gy typically in a single fraction) ( 10 , 11 ).…”

Section: Sabrmentioning

confidence: 99%

Advances in Radiobiology of Stereotactic Ablative Radiotherapy

et al. 2020

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Radiotherapy (RT) has been developed with remarkable technological advances in recent years. The accuracy of RT is dramatically improved and accordingly high dose radiation of the tumors could be precisely projected. Stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT), also known as stereotactic ablative radiotherapy (SABR), are rapidly becoming the accepted practice in treating solid small sized tumors. Compared with the conventional fractionation external beam radiotherapy (EBRT), SABR with very high dose per fraction and hypo-fractionated irradiation yields convincing and satisfied therapeutic effects with low toxicity, since tumor cells could be directly ablated like radiofrequency ablation (RFA). The impressive clinical efficacy of SABR is greater than expected by the linear quadratic model and the conventional radiobiological principles, i.e., 4 Rs of radiobiology (reoxygenation, repair, redistribution, and repopulation), which may no longer be suitable for the explanation of SABR's ablation effects. Based on 4 Rs of radiobiology, 5 Rs of radiobiology emphasizes the intrinsic radiosensitivity of tumor cells, which may correlate with the responsiveness of SABR. Meanwhile, SABR induced the radiobiological alteration including vascular endothelial injury and the immune activation, which has been indicated by literature reported to play a crucial role in tumor control. However, a comprehensive review involving these advances in SABR is lacking. In this review, advances in radiobiology of SABR including the role of the 4 Rs of radiobiology and potential radiobiological factors for SABR will be comprehensively reviewed and discussed.

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Section: Sabrmentioning

confidence: 99%

Advances in Radiobiology of Stereotactic Ablative Radiotherapy

et al. 2020

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“…Trials are underway to evaluate SBRTs efficacy in other disease sites, including advanced lung cancer, pancreatic cancer, sarcoma, and oligometastatic disease. Stereotactic body radiotherapy is also an attractive option in a re‐irradiation setting for spinal, thoracic, and head and neck cancers …”

Section: Opening Statementsmentioning

confidence: 99%

Three discipline collaborative radiation therapy (3DCRT) special debate: The single most important factor in determining the future of SBRT is immune response

Grassberger

Huber

Jacob

et al. 2019

J Applied Clin Med Phys

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Three discipline collaborative radiation therapy (3DCRT) special debate: The single most important factor in determining the future of SBRT is immune response RAD IATION THERAPY (3DCRT) DEBATE SERIESRadiation Oncology is a highly multidisciplinary medical specialty, drawing significantly from three scientific disciplinesmedicine, physics, and biology. As a result, discussion of controversies or changes in practice within radiation oncology involves input from all three disciplines. For this reason, significant effort has been expended recently to foster collaborative multidisciplinary research in radiation oncology, with substantial demonstrated benefit. 1,2 In light of these results, we endeavor here to adopt this "team-science" approach to the traditional debates featured in this journal. This article is part of a series of special debates entitled "Three Discipline Collaborative Radiation Therapy (3DCRT)" in which each debate team will include a radiation oncologist, medical physicist, and radiobiologist. We hope that this format will not only be engaging for the readership but will also foster further collaboration in the science and clinical practice of radiation oncology.

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“…In recent years, the demand for stereotactic body radiation therapy (SBRT) has increased, and its application is expanding to more disease sites. [1][2][3][4] Stereotactic body radiation therapy delivers a higher dose per fraction than conventional radiation therapy, so the adverse effects of differences between the planned and delivered dose distribution are much greater. [5][6][7] Such delivery errors cause not only decreased dose coverage of the target but also serious side effects for the organ at risk (OAR).…”

Section: Introductionmentioning

confidence: 99%

Real‐time in vivo dosimetry system based on an optical fiber‐coupled microsized photostimulable phosphor for stereotactic body radiation therapy

et al. 2020

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Purpose: To develop an in vivo dosimeter system for stereotactic body radiation therapy (SBRT) that can perform accurate and precise real-time measurements, using a microsized amount of a photostimulable phosphor (PSP), BaFBr:Eu 2+. Methods: The sensitive volume of the PSP was 1.26 9 10 À5 cm 3. The dosimeter system was designed to apply photostimulation to the PSP after the decay of noise signals, in synchronization with the photon beam pulse of a linear accelerator (LINAC), to eliminate the noise signals completely using a time separation technique. The noise signals included stem signals, and radioluminescence signals generated by the PSP. In addition, the dosimeter system was built on a storage-type dosimeter that could read out a signal after an arbitrary preset number of photon beam pulses were incident. First, the noise and photostimulated luminescence (PSL) signal decay times were measured. Subsequently, we confirmed that the PSL signals could be exclusively read out within the photon beam pulse interval. Finally, using a water phantom, the basic characteristics of the dosimeter system were demonstrated under SBRT conditions, and the feasibility for clinical application was investigated. The reproducibility, dose linearity, dose-rate dependence, temperature dependence, and angular dependence were evaluated. The feasibility was confirmed by measurements at various dose gradients and using a representative treatment plan for a metastatic liver tumor. A clinical plan was created with a two-arc beam volumetric modulated arc therapy using a 10 MV flattening filter-free photon beam. For the water phantom measurements, the clinical plan was compiled into a plan with a fixed gantry angle of 0°. To evaluate the energy dependence during SBRT, the percent depth dose (PDD) was measured and compared with those calculated via Monte Carlo (MC) simulations. Results: All the PSL signals could be read out while eliminating the noise signals within the minimum pulse interval of the LINAC. Stable real-time measurements could be performed with a time resolution of 56 ms (i.e., number of pulses = 20). The dose linearity was good in the dose range of 0.01-100 Gy. The measurements agreed within 1% at dose rates of 40-2400 cGy/min. The temperature and angular dependence were also acceptable since these dependencies had only a negligible effect on the measurements in SBRT. At a dose gradient of 2.21 Gy/mm, the measured dose agreed with that calculated using a treatment planning system (TPS) within the measurement uncertainties due to the probe position. For measurements using a representative treatment plan, the measured dose

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Developments in Stereotactic Body Radiotherapy

Cited by 16 publications

References 75 publications

Advances in Radiobiology of Stereotactic Ablative Radiotherapy

Advances in Radiobiology of Stereotactic Ablative Radiotherapy

Three discipline collaborative radiation therapy (3DCRT) special debate: The single most important factor in determining the future of SBRT is immune response

Real‐time in vivo dosimetry system based on an optical fiber‐coupled microsized photostimulable phosphor for stereotactic body radiation therapy

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