Planning benchmark study for SBRT of early stage NSCLC

TY - JOUR

T1 - Planning benchmark study for SBRT of early stage NSCLC

T2 - Results of the DEGRO Working Group Stereotactic Radiotherapy

AU - Moustakis, Christos

AU - Blanck, Oliver

AU - Ebrahimi Tazehmahalleh, Fatemeh

AU - Ka Heng Chan, Mark

AU - Ernst, Iris

AU - Krieger, Thomas

AU - Duma, Marciana-Nona

AU - Oechsner, Markus

AU - Ganswindt, Ute

AU - Heinz, Christian

AU - Alheit, Horst

AU - Blank, Hilbert

AU - Nestle, Ursula

AU - Wiehle, Rolf

AU - Kornhuber, Christine

AU - Ostheimer, Christian

AU - Petersen, Cordula

AU - Pollul, Gerhard

AU - Baus, Wolfgang

AU - Altenstein, Georg

AU - Beckers, Eric

AU - Jurianz, Katrin

AU - Sterzing, Florian

AU - Kretschmer, Matthias

AU - Seegenschmiedt, Heinrich

AU - Maass, Torsten

AU - Droege, Stefan

AU - Wolf, Ulrich

AU - Schoeffler, Juergen

AU - Haverkamp, Uwe

AU - Eich, Hans Theodor

AU - Guckenberger, Matthias

PY - 2017/10

Y1 - 2017/10

N2 - PURPOSE: The aim was to evaluate stereotactic body radiation therapy (SBRT) treatment planning variability for early stage nonsmall cell lung cancer (NSCLC) with respect to the published guidelines of the Stereotactic Radiotherapy Working Group of the German Society for Radiation Oncology (DEGRO).MATERIALS AND METHODS: Planning computed tomography (CT) scan and the structure sets (planning target volume, PTV; organs at risk, OARs) of 3 patients with early stage NSCLC were sent to 22 radiotherapy departments with SBRT experience: each department was asked to prepare a treatment plan according to the DEGRO guidelines. The prescription dose was 3 fractions of 15 Gy to the 65% isodose.RESULTS: In all, 87 plans were generated: 36 used intensity-modulated arc therapy (IMAT), 21 used three-dimensional conformal radiation therapy (3DCRT), 6 used static field intensity-modulated radiation therapy (SF-IMRT), 9 used helical radiotherapy and 15 used robotic radiosurgery. PTV dose coverage and simultaneously kept OARs doses were within the clinical limits published in the DEGRO guidelines. However, mean PTV dose (mean 58.0 Gy, range 52.8-66.4 Gy) and dose conformity indices (mean 0.75, range 0.60-1.00) varied between institutions and techniques (p ≤ 0.02). OARs doses varied substantially between institutions, but appeared to be technique independent (p = 0.21).CONCLUSION: All studied treatment techniques are well suited for SBRT of early stage NSCLC according to the DEGRO guidelines. Homogenization of SBRT practice in Germany is possible through the guidelines; however, detailed treatment plan characteristics varied between techniques and institutions and further homogenization is warranted in future studies and recommendations. Optimized treatment planning should always follow the ALARA (as low as reasonably achievable) principle.

AB - PURPOSE: The aim was to evaluate stereotactic body radiation therapy (SBRT) treatment planning variability for early stage nonsmall cell lung cancer (NSCLC) with respect to the published guidelines of the Stereotactic Radiotherapy Working Group of the German Society for Radiation Oncology (DEGRO).MATERIALS AND METHODS: Planning computed tomography (CT) scan and the structure sets (planning target volume, PTV; organs at risk, OARs) of 3 patients with early stage NSCLC were sent to 22 radiotherapy departments with SBRT experience: each department was asked to prepare a treatment plan according to the DEGRO guidelines. The prescription dose was 3 fractions of 15 Gy to the 65% isodose.RESULTS: In all, 87 plans were generated: 36 used intensity-modulated arc therapy (IMAT), 21 used three-dimensional conformal radiation therapy (3DCRT), 6 used static field intensity-modulated radiation therapy (SF-IMRT), 9 used helical radiotherapy and 15 used robotic radiosurgery. PTV dose coverage and simultaneously kept OARs doses were within the clinical limits published in the DEGRO guidelines. However, mean PTV dose (mean 58.0 Gy, range 52.8-66.4 Gy) and dose conformity indices (mean 0.75, range 0.60-1.00) varied between institutions and techniques (p ≤ 0.02). OARs doses varied substantially between institutions, but appeared to be technique independent (p = 0.21).CONCLUSION: All studied treatment techniques are well suited for SBRT of early stage NSCLC according to the DEGRO guidelines. Homogenization of SBRT practice in Germany is possible through the guidelines; however, detailed treatment plan characteristics varied between techniques and institutions and further homogenization is warranted in future studies and recommendations. Optimized treatment planning should always follow the ALARA (as low as reasonably achievable) principle.

KW - Benchmarking

KW - Carcinoma, Non-Small-Cell Lung

KW - Germany

KW - Guideline Adherence

KW - Humans

KW - Lung Neoplasms

KW - Neoplasm Staging

KW - Prevalence

KW - Radiosurgery

KW - Radiotherapy Dosage

KW - Radiotherapy Planning, Computer-Assisted

KW - Reproducibility of Results

KW - Sensitivity and Specificity

KW - Treatment Outcome

KW - Journal Article

KW - Multicenter Study

U2 - 10.1007/s00066-017-1151-8

DO - 10.1007/s00066-017-1151-8

M3 - SCORING: Journal article

C2 - 28567503

VL - 193

SP - 780

EP - 790

JO - STRAHLENTHER ONKOL

JF - STRAHLENTHER ONKOL

SN - 0179-7158

IS - 10

ER -