Organ at Risk Dose Constraints in SABR: A Systematic Review of Active Clinical Trials

Gerhard, Serenna G.; Palma, David A.; Arifin, Andrew J.; Louie, Alexander V.; Li, George J.; Al-Shafa, Faiez; Cheung, Patrick; Rodrigues, George; Bassim, Carol W.; Corkum, Mark T.

doi:10.1016/j.prro.2021.03.005

Cited by 41 publications

(49 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The contours were extracted as labelmaps from 3DSlicer and read into Python. Most underlying values of α and β were extracted from reviews by Kehwar et al [37] and van Leeuwen et al [38], with additional values from other publications [3,[39][40][41][42][43]. In cases of insufficient evidence, we chose a default αvalue of 0.1 Gy −1 and a default β-value of 0.05 Gy −2 for normal tissue [44].…”

Section: Dosimetric Evaluation and Equivalent Uniform Dosementioning

confidence: 99%

See 1 more Smart Citation

Treatment Planning Study for Microbeam Radiotherapy Using Clinical Patient Data

Kraus

Winter

Yating

et al. 2022

Cancers

View full text Add to dashboard Cite

Microbeam radiotherapy (MRT) is a novel, still preclinical dose delivery technique. MRT has shown reduced normal tissue effects at equal tumor control rates compared to conventional radiotherapy. Treatment planning studies are required to permit clinical application. The aim of this study was to establish a dose comparison between MRT and conventional radiotherapy and to identify suitable clinical scenarios for future applications of MRT. We simulated MRT treatment scenarios for clinical patient data using an inhouse developed planning algorithm based on a hybrid Monte Carlo dose calculation and implemented the concept of equivalent uniform dose (EUD) for MRT dose evaluation. The investigated clinical scenarios comprised fractionated radiotherapy of a glioblastoma resection cavity, a lung stereotactic body radiotherapy (SBRT), palliative bone metastasis irradiation, brain metastasis radiosurgery and hypofractionated breast cancer radiotherapy. Clinically acceptable treatment plans were achieved for most analyzed parameters. Lung SBRT seemed the most challenging treatment scenario. Major limitations comprised treatment plan optimization and dose calculation considering the tissue microstructure. This study presents an important step of the development towards clinical MRT. For clinical treatment scenarios using a sophisticated dose comparison concept based on EUD and EQD2, we demonstrated the capability of MRT to achieve clinically acceptable dose distributions.

show abstract

Section: Dosimetric Evaluation and Equivalent Uniform Dosementioning

confidence: 99%

“…For all PTVs, we present the mean dose as well as the dose received by 2% and 98% of the PTV. For organs at risk, we compared results to dosimetric constraints from the literature [39][40][41][42][43]45] after conversion to EQD2.…”

Section: Dosimetric Evaluation and Equivalent Uniform Dosementioning

confidence: 99%

Treatment Planning Study for Microbeam Radiotherapy Using Clinical Patient Data

Kraus

Winter

Yating

et al. 2022

Cancers

View full text Add to dashboard Cite

show abstract

“… 14 Planning constraints were mainly derived from the UK SABR Consortium Report. 13 , 15 , 16 , 17 SBRT was performed with the DIBH plans as all dosimetric parameters were more favorable compared with the 4D-CT plans. Summed (left and right lesion) DIBH and 4D-CT plans were additionally evaluated offline (Velocity; Varian, Palo Alto, CA).…”

Section: Case Reportmentioning

confidence: 99%

Motion Management in a Patient With Tracheostomy During Lung Stereotactic Body Radiation Therapy: Breath Hold Is Worth a Try

Lena

Abo-Madyan

Huber

et al. 2022

Advances in Radiation Oncology

View full text Add to dashboard Cite

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

show abstract

“…17,25 SBRT planning for adrenal metastases is often a challenge due to anatomic proximity of serial risk organs such as the duodenum, small bowel and stomach. 26 Violating dose constraints can lead to lifethreatening complications [27][28][29] making a complex planning process, image-guided RT (IGRT), and appropriate motion management strategies necessary. 30 To avoid violating risk organ tolerance, compromises in the target dose can be necessary resulting in heterogenous dose and fractionation schedules.…”

Section: Introductionmentioning

confidence: 99%

“…SBRT planning for adrenal metastases is often a challenge due to anatomic proximity of serial risk organs such as the duodenum, small bowel and stomach 26 . Violating dose constraints can lead to life‐threatening complications 27‐29 making a complex planning process, image‐guided RT (IGRT), and appropriate motion management strategies necessary 30 .…”

Section: Introductionmentioning

confidence: 99%

Stereotactic body radiotherapy of adrenal metastases—A dose‐finding study

Buergy

Würschmidt

Gkika

et al. 2022

Intl Journal of Cancer

View full text Add to dashboard Cite

Optimal doses for the treatment of adrenal metastases with stereotactic radiotherapy (SBRT) are unknown. We aimed to identify dose-volume cut-points associated with decreased local recurrence rates (LRR). A multicenter database of patients with adrenal metastases of any histology treated with SBRT (biologically effective dose, BED10 ≥50 Gy, ≤12 fractions) was analyzed. Details on dose-volume parameters were required (planning target volume: PTV-D98%, PTV-D50%, PTV-D2%; gross tumor volume: GTV-D50%, GTV-mean). Cut-points for LRR were optimized using the R maxstat package. One hundred and ninety-six patients with 218 lesions were included, the largest histopathological subgroup was adenocarcinoma (n = 101). Cut-point optimization resulted in significant cut-points for PTV-D50% (BED10: 73.2 Gy; P = .003), GTV-D50% (BED10: 74.2 Gy; P = .006), GTV-mean (BED10: 73.0 Gy; P = .007), and PTV-D2% (BED10: 78.0 Gy; P = .02) but not for the PTV-D98% (P = .06). Differences in LRR were clinically relevant (LRR ≥ doubled for cut-points that were not achieved). Further dose-escalation was not associated with further improved LRR. PTV-D50%, GTV-D50%, and GTV-mean cut-points were also associated with significantly improved LRR in the adenocarcinoma subgroup. Separate dose optimizations indicated a lower cutpoint for the PTV-D50% (BED10: 69.1 Gy) in adenocarcinoma lesions, other values were similar (<2% difference). Associations of cut-points with overall survival (OS) and progression-free survival were not significant but durable freedom from local recurrence was associated with OS in a landmark model (P < .001). To achieve a significant

show abstract

Organ at Risk Dose Constraints in SABR: A Systematic Review of Active Clinical Trials

Cited by 41 publications

References 21 publications

Treatment Planning Study for Microbeam Radiotherapy Using Clinical Patient Data

Treatment Planning Study for Microbeam Radiotherapy Using Clinical Patient Data

Motion Management in a Patient With Tracheostomy During Lung Stereotactic Body Radiation Therapy: Breath Hold Is Worth a Try

Stereotactic body radiotherapy of adrenal metastases—A dose‐finding study

Contact Info

Product

Resources

About