Stereotactic body radiation therapy: The report of AAPM Task Group 101

University of Virginia Health System, Charlottesville, Virginia 22908, USA.
Medical Physics (Impact Factor: 3.01). 08/2010; 37(8):4078-101. DOI: 10.1118/1.3438081
Source: PubMed

ABSTRACT 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, Jul 16, 2015
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    Physica Medica 08/2014; DOI:10.1016/j.ejmp.2014.07.342 · 1.85 Impact Factor
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    • "NA Total dose (Gy) [r] 81 54 (45–54) [36–60] 79 70.2 (70.2–70.2) [60–72.3] NA Fraction (#) [r] 81 3 (3–3) [2] [3] [4] [5] 79 26 (26–26) [17–30] NA "
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    ABSTRACT: Stereotactic body radiation therapy (SBRT) and accelerated hypofractionated radiation therapy (AHRT) have favorable local control (LC) relative to conventional fractionation in the treatment of stage I non-small cell lung cancer (NSCLC). We report the results of our single institution experience with the treatment of early stage NSCLC with SBRT or AHRT in cases where SBRT was felt to be suboptimal. One hundred and sixty patients with Stage 1 and node negative Stage 2 NSCLC were treated with SBRT or AHRT from 2003 to 2011. Median follow-up was 29.4 and 19 months (mo), respectively. The median dose was 54Gy in 3 fractions (fx) (SBRT) and 70.2Gy in 26 fx (AHRT). Acute and late toxicities (tox) were graded (G) per CTCAE v4. Time to local (LF), regional (RF) and distant (DF) failure were estimated using the Kaplan-Meier method. The impact of patient and tumor related factors on LF were estimated by multivariate Cox proportional hazard model. Three-year LC rates were 87.7% (SBRT) and 71.7% (AHRT). The 3-year freedom from DF was 73.3% and 68.1%. Median OS was 38.4 (95% CI 29.7-51.6) and 35 (95% CI 22-48.3) mo. No G3 or 4 tox were observed. At 1 year, 30% and 50% of complications resolved, while (5-6%) had persistent chest wall pain. Multivariate analysis demonstrated that increasing dose per fraction and tumor size (>5.5 vs. 4cm) in the AHRT and SBRT group were found to be associated with a reduced (HR 0.33 95% CI 0.13-0.84, p=0.021) and increased (HR: 6.372 95% CI 1.23-32.92, p=0.027) hazard for local failure respectively. Our results compare favorably with other reports of treatment for early stage NSCLC. AHRT patients had comparable LC despite increased size and central disease. Toxicity was limited and overall survival, regional and distant recurrences were similar between groups.
    Lung cancer (Amsterdam, Netherlands) 04/2014; 85(1). DOI:10.1016/j.lungcan.2014.04.003 · 3.74 Impact Factor
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    • "The first major feature of the RA system is its excellent dose conformity, which results from the arc therapy nature [11] [17] and a fine spatial resolution (5 mm in the central area) of the multi-leaf collimator [14]. This improvement in the conformity of the RA system allowed for a better coverage of target areas. "
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    ABSTRACT: The aim of this study was to evaluate the feasibility and dose distribution of two different stereotactic body radiation therapy (SBRT) techniques, isocentric RapidArc (RA) and non-isocentric CyberKnife (CK), for the treatment of localized prostate cancer. Two groups of patients (Groups 1 and 2 with ten patients per group) treated with CK were re-planned with RA. The patients were grouped according to the rectum constraint used (Group1, maximum dose for rectum; Group 2, dose-volume histogram for rectum). The prescription dose was 37.5 Gy in five fractions. The two SBRT techniques were compared by target coverage, normal tissue sparing, and dose distribution parameters. Monitor units (MUs) and the delivery time were likewise compared to assess delivery efficiency. The RA plans consistently exhibited superior PTV coverage and better rectum sparing at low doses in the both groups. The conformity and heterogeneity indices of the RA plans were better than the CK plans. Additionally, the RA plans resulted in fewer low-dose regions, lower MUs, and faster delivery times than the CK plans. The good dosimetric distribution and shorter delivery time make RA an attractive SBRT technique for the treatment of localized prostate cancer.
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