Lung stereotactic ablative body radiotherapy: A large scale multi-institutional planning comparison for interpreting results of multi-institutional studies

Giglioli, F.R.; Strigari, Lidia; Ragona, Riccardo; Borzì, G.; Cagni, E.; Carbonini, C.; Clemente, Stefania; Consorti, R.; Gawhary, Randa El; Esposito, Marco; Falco, M.D.; Fedele, David A.; Fiandra, C.; Frassanito, M. C.; Landoni, V.; Loi, G.; Lorenzini, Elena; Malisan, M.R.; Marino, C.; Menghi, E.; Nardiello, B.; Nigro, R.; Oliviero, C.; Pastore, G.; Quattrocchi, M.; Ruggieri, R.; Redaelli, I.; Reggiori, G.; Russo, S.; Villaggi, E.; Casati, M.; Mancosu, P.

doi:10.1016/j.ejmp.2016.03.015

Cited by 54 publications

(32 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are many plan quality metrics [6][7][8][9] which aim to quantify the radiotherapy goals of providing adequate target coverage whilst minimizing the normal tissue dose, some combined into a single metric [10,11]. Published guidance aims to quantify what plan quality should be achieved in lung SBRT; but guidance is currently limited to the ROSEL study [12] and RTOG 0813 [13], which both include the "R100%" and "R50%" metrics (defined in Methods).…”

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

View full text Add to dashboard Cite

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.

show abstract

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

View full text Add to dashboard Cite

show abstract

“…A value of 1 implies high planning target volume coverage and minimal unnecessary irradiation of surrounding tissues. van't Riet A et al suggested that treatment with a CI above 0.60 indicates optimal treatment planning[ 20 , 28 ]. In our study, the CI for PTV of SBT and SBRT were 0.77±0.05 and 0.81±0.06, respectively ( p = 0.031).…”

Section: Discussionmentioning

confidence: 99%

Dosimetric comparison of CT-guided iodine-125 seed stereotactic brachytherapy and stereotactic body radiation therapy in the treatment of NSCLC

Zhang

Yuan

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

This study aimed to assess the dosimetric differences between iodine-125 seed stereotactic brachytherapy (SBT) and stereotactic body radiation therapy (SBRT) in the treatment of non-small cell lung cancer (NSCLC). An SBT plan and an SBRT plan were generated for eleven patients with T1-2 NSCLC. Prescription of the dose and fractionation (fr) for SBRT was 48Gy/4fr. The planning aim for SBT was D90 (dose delivered to 90% of the target volume)≥120Gy. Student’s paired t test was used to compare the dosimetric parameters. The SBT and SBRT plans had comparable PTV D90 (104.73±2.10Gyvs.107.64±2.29Gy), and similar mean volume receiving 100% of the prescription dose (V100%) (91.65% vs.92.44%, p = 0.410). The mean volume receiving 150% of the prescribed dose (V150%) for SBT was 64.71%, whereas it was 0% for SBRT. Mean heterogeneity index (HI) deviation for SBT vs. SBRT was 0.73 vs. 0.19 (p<0.0001), and the mean conformity index (CI) for SBT vs. SBRT was 0.77 vs. 0.81 (p = 0.031). The mean lung doses (MLD) in SBT were significantly lower than those in SBRT (1.952±0.713 vs. 5.618±2.009, p<0.0001). In conclusion, compared with SBRT, SBT can generate a comparable dose within PTV, while the organs at risk (OARs) only receive a very low dose. But the HI and CI in SBT were lower than in SBRT.

show abstract

“…Today, many institutions utilise modern delivery techniques for SBRT, such as intensity-modulated radiotherapy and volumetric-modulated arc radiotherapy [14][15][16]. In conjunction with inverse treatment plan optimization it is possible to design highly conformal dose distributions, even in inhomogeneous anatomies [17,18].…”

Section: Current Clinical Workflow For Lung Sbrtmentioning

confidence: 99%

MRI-guided lung SBRT: Present and future developments

2017

View full text Add to dashboard Cite

Stereotactic body radiotherapy (SBRT) is rapidly becoming an alternative to surgery for the treatment of early-stage non-small cell lung cancer patients. Lung SBRT is administered in a hypo-fractionated, conformal manner, delivering high doses to the target. To avoid normal-tissue toxicity, it is crucial to limit the exposure of nearby healthy organs-at-risk (OAR). Current image-guided radiotherapy strategies for lung SBRT are mostly based on X-ray imaging modalities. Although still in its infancy, magnetic resonance imaging (MRI) guidance for lung SBRT is not exposure-limited and MRI promises to improve crucial soft-tissue contrast. Looking beyond anatomical imaging, functional MRI is expected to inform treatment decisions and adaptations in the future. This review summarises and discusses how MRI could be advantageous to the different links of the radiotherapy treatment chain for lung SBRT: diagnosis and staging, tumour and OAR delineation, treatment planning, and inter-or intrafractional motion management. Special emphasis is placed on a new generation of hybrid MRI treatment devices and their potential for real-time adaptive radiotherapy.

show abstract

Lung stereotactic ablative body radiotherapy: A large scale multi-institutional planning comparison for interpreting results of multi-institutional studies

Cited by 54 publications

References 27 publications

Multi-center evaluation of dose conformity in stereotactic body radiotherapy

Multi-center evaluation of dose conformity in stereotactic body radiotherapy

Dosimetric comparison of CT-guided iodine-125 seed stereotactic brachytherapy and stereotactic body radiation therapy in the treatment of NSCLC

MRI-guided lung SBRT: Present and future developments

Contact Info

Product

Resources

About