Benedict SH, Yenice KM, Followill D, et al. Stereotactic body radiation therapy: the report of AAPM Task Group 101

University of Virginia Health System, Charlottesville, Virginia 22908, USA.
Medical Physics (Impact Factor: 2.64). 08/2010; 37(8):4078-101. DOI: 10.1118/1.3438081
Source: PubMed


Task Group 101 of the AAPM has prepared this report for medical physicists, clinicians, and therapists in order to outline the best practice guidelines for the external-beam radiation therapy technique referred to as stereotactic body radiation therapy (SBRT). The task group report includes a review of the literature to identify reported clinical findings and expected outcomes for this treatment modality. Information is provided for establishing a SBRT program, including protocols, equipment, resources, and QA procedures. Additionally, suggestions for developing consistent documentation for prescribing, reporting, and recording SBRT treatment delivery is provided.

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Available from: Bill J Salter, Oct 04, 2015
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    • "While differences in treatment capabilities exist in the various lung SABR delivery platforms, a systematic review found no differences in overall survival for ES-NSCLC when using different technologies [83]. Published guidelines in both North America [84] [85] [86] and the European Union [47] [87] have supported institutional credentialing procedures, standardization of normal tissue tolerances, and increased discourse on the use of SABR in a multidisciplinary setting. "
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    ABSTRACT: The use of stereotactic ablative radiotherapy (SABR) for early-stage non-small cell lung cancer is growing rapidly, particularly since it has become the recommended therapy for unfit patients in current European and North American guidelines. As three randomized trials comparing surgery and SABR closed prematurely because of poor accrual, clinicians are faced with a dilemma in individual patient decision-making. Radiation oncologists, in particular, should be aware of the data from comparative effectiveness studies that suggest similar survival outcomes irrespective of local treatment modality. The necessity of obtaining a pathological diagnosis, particularly in frail patients prior to treatment remains a challenge, and this topic was addressed in recent European recommendations. Awareness of the high incidence of a second primary lung cancer in survivors, as well as other competing causes of mortality, is needed. The challenges in distinguishing focal scarring from recurrence after SABR also need to be appreciated by multidisciplinary tumor boards. With a shift in focus toward patient-centered decision-making, clinicians will need to be aware of these new developments and communicate effectively with patients, to ensure that treatment decisions are reflective of patient preferences. Priorities for additional research in the area are proposed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Radiotherapy and Oncology 12/2014; 114(2). DOI:10.1016/j.radonc.2014.11.036 · 4.36 Impact Factor
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    • "Common criteria chosen to evaluate the treatment plans were taken from the National Comprehensive Cancer Network (NCCN) guidelines for Non-small cell lung cancer [21], Timmerman et al. [22], and AAPM task group no. 101 report on SABR for lung cancer [23]. The constraints adopted to accept a treatment plan were: "
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    ABSTRACT: Boron Neutron Capture Therapy (BNCT) is a radiotherapy that combines biological targeting and high LET radiation. It consists in the enrichment of tumour with (10)B and in the successive irradiation of the target with low energy neutrons producing charged particles that mainly cause non-repairable damages to the cells. The feasibility to treat Non Small Cells Lung Cancer (NSCLC) with BNCT was explored. This paper proposes a new approach to determine treatment plans, introducing the possibility to choose the irradiation start and duration to maximize the tumour dose. A Tumour Control Probability (TCP) suited for lung BNCT as well as other high dose radiotherapy schemes was also introduced. Treatment plans were evaluated in localized and disseminated lung tumours. Semi-ideal and real energy spectra beams were employed to assess the best energy range and the performance of non-tailored neutron sources for lung tumour treatments. The optimal neutron energy is within [500 eV-3 keV], lower than the 10 keV suggested for the treatment of deep-seated tumours in the brain. TCPs higher than 0.6 and up to 0.95 are obtained for all cases. Conclusions drawn from [Suzuki et al., Int Canc Conf J 1 (4) (2012) 235-238] supporting the feasibility of BNCT for shallow lung tumours are confirmed, however discussions favouring the treatment of deeper lesions and disseminated disease are also opened. Since BNCT gives the possibility to deliver a safe and potentially effective treatment for NSCLC, it can be considered a suitable alternative for patients with few or no treatment options.
    Physica Medica 08/2014; 30(8). DOI:10.1016/j.ejmp.2014.07.342 · 2.40 Impact Factor
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    • "The same magnitudes of errors introduced in MLCs might affect the dose distribution of SBRT differently than that of conventional radiotherapy since an indication for SBRT is generally a small localized tumor [18]. Thus, the criterion of 2%/2 mm suggested by the recent studies for patient-specific VMAT QA is already widely-adopted for SBRT VMAT QA in many institutions [18]. "
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    ABSTRACT: Background To investigate the sensitivity of various gamma criteria used in the gamma-index method for patient-specific volumetric modulated arc therapy (VMAT) quality assurance (QA) for stereotactic body radiation therapy (SBRT) using a flattening filter free (FFF) photon beam. Methods Three types of intentional misalignments were introduced to original high-definition multi-leaf collimator (HD-MLC) plans. The first type, referred to Class Out, involved the opening of each bank of leaves. The second type, Class In, involved the closing of each bank of leaves. The third type, Class Shift, involved the shifting of each bank of leaves towards the ground. Patient-specific QAs for the original and the modified plans were performed with MapCHECK2 and EBT2 films. The sensitivity of the gamma-index method using criteria of 1%/1 mm, 1.5%/1.5 mm, 1%/2 mm, 2%/1 mm and 2%/2 mm was investigated with absolute passing rates according to the magnitudes of MLCs misalignments. In addition, the changes in dose-volumetric indicators due to the magnitudes of MLC misalignments were investigated. The correlations between passing rates and the changes in dose-volumetric indicators were also investigated using Spearman’s rank correlation coefficient (γ). Results The criterion of 2%/1 mm was able to detect Class Out and Class In MLC misalignments of 0.5 mm and Class Shift misalignments of 1 mm. The widely adopted clinical criterion of 2%/2 mm was not able to detect 0.5 mm MLC errors of the Class Out or Class In types, and also unable to detect 3 mm Class Shift errors. No correlations were observed between dose-volumetric changes and gamma passing rates (γ < 0.8). Conclusions Gamma criterion of 2%/1 mm was found to be suitable as a tolerance level with passing rates of 90% and 80% for patient-specific VMAT QA for SBRT when using MapCHECK2 and EBT2 film, respectively.
    Radiation Oncology 07/2014; 9(1):167. DOI:10.1186/1748-717X-9-167 · 2.55 Impact Factor
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