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：13

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

页码：214 / 227

页数：14

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