Dose prescription and reporting in stereotactic body radiotherapy: A multi-institutional study.

Autor: Das IJ; Department of Radiation Oncology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Electronic address: indra.das@nm.org., Yadav P; Department of Radiation Oncology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Andersen AD; Department of Radiation Oncology, Renown Medical Center, Reno, NV, USA., Chen ZJ; Department of Therapeutic Radiology, Yale University, New haven, CT, USA., Huang L; Department of Radiation Oncology, University of Utah, Salt Lake City, UT, USA., Langer MP; Department of Radiation Oncology, Indiana University Health, Indianapolis, IN, USA., Lee C; Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA., Li L; Division of Biostatistics, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA., Popple RA; Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL, USA., Rice RK; Department of Radiation Medicine and Applied Science, University of California, San Diego, CA, USA., Schiff PB; Department of Radiation Oncology, New York University Grossman School of Medicine, New York, NY, USA., Zhu TC; Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA., Abazeed ME; Department of Radiation Oncology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2023 May; Vol. 182, pp. 109571. Date of Electronic Publication: 2023 Feb 22.
DOI: 10.1016/j.radonc.2023.109571
Abstrakt: Background and Purpose: Radiation dose prescriptions are foundational for optimizing treatment efficacy and limiting treatment-related toxicity. We sought to assess the lack of standardization of SBRT dose prescriptions across institutions.
Materials & Methods: Dosimetric data from 1298 patients from 9 academic institutions treated with IMRT and VMAT were collected. Dose parameters D 100 , D 98 , D 95 , D 50 , and D 2 were used to assess dosimetric variability.
Results: Disease sites included lung (48.3 %) followed by liver (29.7 %), prostate (7.5 %), spine (6.8 %), brain (4.1 %), and pancreas (2.5 %). The PTV volume in lung varied widely with bimodality into two main groups (22.0-28.7 cm 3 ) and (48.0-67.1 cm 3 ). A hot spot ranging from 120-150 % was noted in nearly half of the patients, with significant variation across institutions. A D 50  ≥ 110 % was found in nearly half of the institutions. There was significant dosimetric variation across institutions.
Conclusions: The SBRT prescriptions in the literature or in treatment guidelines currently lack nuance and hence there is significant variation in dose prescriptions across academic institutions. These findings add greater importance to the identification of dose parameters associated with improved clinical outcome comparisons as we move towards more hypofractionated treatments. There is a need for standardized reporting to help institutions in adapting treatment protocols based on the outcome of clinical trials. Dosimetric parameters are subsequently needed for uniformity and thereby standardizing planning guidelines to maximize efficacy, mitigate toxicity, and reduce treatment disparities are urgently needed.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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