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Planning benchmark study for stereotactic body radiation therapy of liver metastases: results of the DEGRO/DGMP working group on stereotactic radiation therapy and radiosurgery : physics contribution

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 inte...

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Main Authors: Moustakis, Christos (Author) , Blanck, Oliver (Author) , Chan, Mark Ka Heng (Author) , Boda-Heggemann, Judit (Author) , Andratschke, Nicolaus (Author) , Duma, Marciana Nona (Author) , Albers, Dirk (Author) , Bäumer, Christian (Author) , Fehr, Roman (Author) , Körber, Stefan A. (Author) , Schmidhalter, Daniel (Author) , Alraun, Manfred (Author) , Baus, Wolfgang W. (Author) , Beckers, Eric (Author) , Dierl, Mathias (Author) , Droege, Stephan (Author) , Tazehmahalleh, Fatemeh Ebrahimi (Author) , Fleckenstein, Jens (Author) , Guckenberger, Matthias (Author) , Heinz, Christian (Author) , Henkenberens, Christoph (Author) , Hennig, Andreas (Author) , Köhn, Janett (Author) , Kornhuber, Christine Barbara (Author) , Krieger, Thomas Heinrich Richard (Author) , Loutfi-Krauss, Britta (Author) , Mayr, Manfred Mayr (Author) , Oechsner, Markus (Author) , Pfeiler, Tina (Author) , Pollul, Gerhard (Author) , Schöffler, Jürgen (Author) , Tümmler, Heiko (Author) , Ullm, Claudia (Author) , Walke, Mathias (Author) , Weigel, Rocco (Author) , Wertman, Martin (Author) , Wiehle, Rolf (Author) , Wiezorek, Tilo (Author) , Wilke, Lotte (Author) , Wolf, Ulrich (Author) , Eich, Hans Theodor (Author) , Schmitt, Daniela (Author)
Format: Article (Journal)
Language:English
Published: 1 May 2022
In: International journal of radiation oncology, biology, physics
Year: 2022, Volume: 113, Issue: 1, Pages: 214-227
ISSN:1879-355X
DOI:10.1016/j.ijrobp.2022.01.008
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ijrobp.2022.01.008
Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0360301622000189
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Author Notes:Christos Moustakis, Oliver Blanck, Mark ka heng Chan, Judit Boda-Heggemann, Nicolaus Andratschke, Marciana-Nona Duma, Dirk Albers, Christian Bäumer, Roman Fehr, Stefan A. Körber, Daniel Schmidhalter, Manfred Alraun, Wolfgang W. Baus, Eric Beckers, Mathias Dierl, Stephan Droege, Fatemeh Ebrahimi Tazehmahalleh, Jens Fleckenstein, Matthias Guckenberger, Christian Heinz, Christoph Henkenberens, Andreas Hennig, Janett Köhn, Christine Kornhuber, Thomas Krieger, Britta Loutfi-Krauss, Manfred Mayr, Markus Oechsner, Tina Pfeiler, Gerhard Pollul, Jürgen Schöffler, Heiko Tümmler, Claudia Ullm, Mathias Walke, Rocco Weigel, Martin Wertman, Rolf Wiehle, Tilo Wiezorek, Lotte Wilke, Ulrich Wolf, Hans Theodor Eich, and Daniela Schmitt
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Summary: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%, GTVD0.1cc, GTVV90%, planning target volume [PTV]V70%) with a prescription dose of GTVD50% = 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 (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 - GTVD50% prescription can be performed in all systems. Treatment plan harmonization was overall successful, with standard deviations for Dmax, PTVD98%, GTVD98%, 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. GTVD50% prescription produced the smallest deviation from target planning objectives and between techniques, followed by the PTVDmax, PTVD98%, PTVD2%, and PTVDmin prescription. Deviations were significant for all combinations but for the PTVDmax prescription compared with GTVD50% and PTVD98%. Based on the various dose prescription methods, all systems significantly differed from each other, whereas GTVD50% 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.
Item Description:Online verfügbar: 22. Januar 2022, Artikelversion: 12. April 2022
Gesehen am 27.02.2024
Physical Description:Online Resource
ISSN:1879-355X
DOI:10.1016/j.ijrobp.2022.01.008

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