Planning Benchmark Study for Stereotactic Body Radiation Therapy of Liver Metastases: Results of the DEGRO/DGMP working group stereotactic radiotherapy and radiosurgery

TY - JOUR

T1 - Planning Benchmark Study for Stereotactic Body Radiation Therapy of Liver Metastases: Results of the DEGRO/DGMP working group stereotactic radiotherapy and radiosurgery

AU - Moustakis, C

AU - Blanck, O

AU - Chan, Mkh

AU - Boda-Heggemann, J

AU - Andratschke, N

AU - Duma, M-N

AU - Albers, D

AU - Bäumer, C

AU - Fehr, R

AU - Körber, S A

AU - Schmidhalter, D

AU - Alraun, M

AU - Baus, W W

AU - Beckers, E

AU - Dierl, M

AU - Droege, S

AU - Ebrahimi Tazehmahalleh, F

AU - Fleckenstein, J

AU - Guckenberger, M

AU - Heinz, C

AU - Henkenberens, C

AU - Hennig, A

AU - Köhn, J

AU - Kornhuber, C

AU - Krieger, T

AU - Loutfi-Krauss, B

AU - Mayr, M

AU - Oechsner, M

AU - Pfeiler, T

AU - Pollul, G

AU - Schöffler, J

AU - Tümmler, H

AU - Ullm, C

AU - Walke, M

AU - Weigel, R

AU - Wertman, M

AU - Wiehle, R

AU - Wiezorek, T

AU - Wilke, L

AU - Wolf, U

AU - Eich, H T

AU - Schmitt, D

N1 - Copyright © 2022. Published by Elsevier Inc.

PY - 2022/5/1

Y1 - 2022/5/1

N2 - 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 × 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 (PTV Dmin, PTV D98%, PTV D2%, PTV Dmax). 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 D max, PTV D98%, GTV D98%, and PTV Dmean 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 PTV Dmax, PTV D98%, PTV D2%, and PTV Dmin prescription. Deviations were significant for all combinations but for the PTV Dmax prescription compared with GTV D50% and PTV D98%. Based on the various dose prescription methods, all systems significantly differed from each other, whereas GTV D50% and PTV D98% 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.

AB - 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 × 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 (PTV Dmin, PTV D98%, PTV D2%, PTV Dmax). 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 D max, PTV D98%, GTV D98%, and PTV Dmean 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 PTV Dmax, PTV D98%, PTV D2%, and PTV Dmin prescription. Deviations were significant for all combinations but for the PTV Dmax prescription compared with GTV D50% and PTV D98%. Based on the various dose prescription methods, all systems significantly differed from each other, whereas GTV D50% and PTV D98% 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.

U2 - 10.1016/j.ijrobp.2022.01.008

DO - 10.1016/j.ijrobp.2022.01.008

M3 - SCORING: Journal article

C2 - 35074434

VL - 113

SP - 214

EP - 227

JO - INT J RADIAT ONCOL

JF - INT J RADIAT ONCOL

SN - 0360-3016

IS - 1

ER -