Planning Benchmark Study for Stereotactic Body Radiation Therapy of Liver Metastases: Results of the DEGRO/DGMP Working Group on Stereotactic Radiation Therapy and Radiosurgery

被引:12
作者
Moustakis, Christos [1 ]
Blanck, Oliver [2 ,3 ]
Chan, Mark Ka Heng [2 ]
Boda-Heggemann, Judit [4 ]
Andratschke, Nicolaus [5 ]
Duma, Marciana-Nona [6 ,7 ]
Albers, Dirk [8 ]
Baeumer, Christian [9 ]
Fehr, Roman [10 ]
Koerber, Stefan A. [11 ]
Schmidhalter, Daniel [12 ,13 ,14 ]
Alraun, Manfred [15 ]
Baus, Wolfgang W. [16 ]
Beckers, Eric [17 ]
Dierl, Mathias [18 ]
Droege, Stephan [19 ]
Tazehmahalleh, Fatemeh Ebrahimi [1 ,16 ]
Fleckenstein, Jens [4 ]
Guckenberger, Matthias [5 ]
Heinz, Christian [20 ]
Henkenberens, Christoph [21 ]
Hennig, Andreas
Koehn, Janett [3 ,22 ]
Kornhuber, Christine [23 ]
Krieger, Thomas [24 ]
Loutfi-Krauss, Britta [3 ,22 ]
Mayr, Manfred [25 ]
Oechsner, Markus [6 ]
Pfeiler, Tina [9 ]
Pollul, Gerhard [26 ]
Schoeffler, Juergen
Tuemmler, Heiko
Ullm, Claudia [27 ]
Walke, Mathias [28 ]
Weigel, Rocco [29 ]
Wertman, Martin [10 ,30 ]
Wiehle, Rolf [31 ]
Wiezorek, Tilo [7 ]
Wilke, Lotte [5 ]
Wolf, Ulrich [32 ]
Eich, Hans Theodor [1 ]
Schmitt, Daniela [11 ,33 ]
机构
[1] Univ Hosp Muenster, Dept Radiat Oncol, Munster, Germany
[2] Univ Med Ctr Schleswig Holstein, Dept Radiat Oncol, Kiel, Germany
[3] Saphir Radiosurg Ctr, Kiel, Germany
[4] Heidelberg Univ, Univ Med Mannheim, Med Fac Mannheim, Dept Radiat Oncol, Mannheim, Germany
[5] Univ Zurich, Univ Hosp Zurich, Dept Radiat Oncol, Zurich, Switzerland
[6] Tech Univ, Univ Hosp Rechts Isar, Dept Radiat Oncol, Jena, Germany
[7] Univ Hosp Jena, Dept Radiat Oncol, Jena, Germany
[8] Univ Med Ctr Hamburg Eppendorf, Dept Radiotherapy & Radiat Oncol, Hamburg, Germany
[9] West German Proton Therapy Ctr, Essen, Germany
[10] Univ Med Rostock, Dept Radiat Oncol, Rostock, Germany
[11] Heidelberg Univ Hosp, Dept Radiat Oncol, Heidelberg, Germany
[12] Bern Univ Hosp, Div Med Radiat Phys, Inselspital, Bern, Switzerland
[13] Bern Univ Hosp, Inselspital, Dept Radiat Oncol, Bern, Switzerland
[14] Univ Bern, Bern, Switzerland
[15] Schwarzwald Baar Hosp, Dept Radiat Oncol, Villingen Schwenningen, Germany
[16] Univ Hosp Cologne, Dept Radiat Oncol, Cologne, Germany
[17] Gamma Knife Ctr Krefeld, Krefeld, Germany
[18] Hosp Bayreuth, Dept Radiat Oncol, Bayreuth, Germany
[19] Lung Clin Hemer, Dept Radiat Oncol, Hemer, Germany
[20] Ludwig Maximilians Univ Munchen, Dept Radiat Oncol, Univ Hosp Munich, Munich, Germany
[21] Hannover Med Sch, Dept Radiat Oncol, Hannover, Germany
[22] Univ Hosp Frankfurt, Dept Radiat Oncol, Frankfurt, Germany
[23] Univ Hosp Halle, Dept Radiat Oncol, Halle, Saale, Germany
[24] Univ Hosp Wuerzburg, Dept Radiat Oncol, Wurzburg, Germany
[25] Private Practice Radiat Oncol South, Kaufbeuren, Germany
[26] Univ Hosp Mainz, Dept Radiat Oncol, Mainz, Germany
[27] Radiol Muenchen, Private Practice Radiat Oncol, Munich, Germany
[28] Univ Hosp Magdeburg, Dept Radiat Oncol, Magdeburg, Germany
[29] Univ Hosp Innsbruck, Dept Radiat Oncol, Innsbruck, Austria
[30] Ernst von Bergmann Hosp, Dept Radiat Oncol, Potsdam, Germany
[31] Univ Hosp Freiburg, Dept Radiat Oncol, Freiburg, Germany
[32] Univ Hosp Leipzig, Dept Radiat Oncol, Leipzig, Germany
[33] Univ Med Ctr Goettingen, Dept Radiat Oncol, Gottingen, Germany
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2022年 / 113卷 / 01期
关键词
RADIOTHERAPY; SBRT; PRINCIPLES; GUIDELINES;
D O I
10.1016/j.ijrobp.2022.01.008
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: Our purpose was to investigate whether liver stereotactic body radiation therapy treatment planning can be harmonized across different treatment planning systems, delivery techniques, and institutions by using a specific prescription method and to minimize the knowledge gap concerning intersystem and interuser differences. We provide best practice guidelines for all used techniques. Methods and Materials: A multiparametric specification of target dose (gross target volume [GTV](D50%), GTV(D0.1cc), GTV(V90%), planning target volume [PTV](V70%)) with a prescription dose of GTV(D50% )= 3 x 20 Gy and organ-at-risk (OAR) limits were distributed with computed tomography and structure sets from 3 patients with liver metastases. Thirty-five institutions provided 132 treatment plans using different irradiation techniques. These plans were first analyzed for target and OAR doses. Four different renormalization methods were performed (PTVDmin, PTVD98%, PTVD2% , PTVDmax). The resulting 660 treatments plans were evaluated regarding target doses to study the effect of dose renormalization to different prescription methods. A relative scoring system was used for comparisons. Results: GTV(D50%) prescription can be performed in all systems. Treatment plan harmonization was overall successful, with standard deviations for Dmax, PTVD98%, GTV(D98%), and PTVDmean of 1.6, 3.3, 1.9, and 1.5 Gy, respectively. Primary analysis showed 55 major deviations from clinical goals in 132 plans, whereas in only <20% of deviations GTV/PTV dose was traded for meeting OAR limits. GTV(D50%) prescription produced the smallest deviation from target planning objectives and between techniques, followed by the PTVDmax, PTVD98%, PTVD2%, and PTV(Dmin )prescription. Deviations were significant for all combinations but for the PTVDmax prescription compared with GTV(D50%) and PTVD98%. Based on the various dose prescription methods, all systems significantly differed from each other, whereas GTV(D50%) and PTVD98% prescription showed the least difference between the systems. Conclusions: This study showed the feasibility of harmonizing liver stereotactic body radiation therapy treatment plans across different treatment planning systems and delivery techniques when a sufficient set of clinical goals is given. (C) 2022 Elsevier Inc. All rights reserved.
引用
收藏
页码:214 / 227
页数:14
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