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01-10-2017 | Original Article

Planning benchmark study for SBRT of early stage NSCLC

Results of the DEGRO Working Group Stereotactic Radiotherapy

Authors: Dr. Christos Moustakis, Dipl.-Phys, Oliver Blanck, Fatemeh Ebrahimi Tazehmahalleh, Mark ka heng Chan, Iris Ernst, Thomas Krieger, Marciana-Nona Duma, Markus Oechsner, Ute Ganswindt, Christian Heinz, Horst Alheit, Hilbert Blank, Ursula Nestle, Rolf Wiehle, Christine Kornhuber, Christian Ostheimer, Cordula Petersen, Gerhard Pollul, Wolfgang Baus, Georg Altenstein, Eric Beckers, Katrin Jurianz, Florian Sterzing, Matthias Kretschmer, Heinrich Seegenschmiedt, Torsten Maass, Stefan Droege, Ulrich Wolf, Juergen Schoeffler, Uwe Haverkamp, Hans Theodor Eich, Matthias Guckenberger

Published in: Strahlentherapie und Onkologie | Issue 10/2017

Abstract

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.

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Title: Planning benchmark study for SBRT of early stage NSCLC
Results of the DEGRO Working Group Stereotactic Radiotherapy
Authors: Dr. Christos Moustakis, Dipl.-Phys
Oliver Blanck
Fatemeh Ebrahimi Tazehmahalleh
Mark ka heng Chan
Iris Ernst
Thomas Krieger
Marciana-Nona Duma
Markus Oechsner
Ute Ganswindt
Christian Heinz
Horst Alheit
Hilbert Blank
Ursula Nestle
Rolf Wiehle
Christine Kornhuber
Christian Ostheimer
Cordula Petersen
Gerhard Pollul
Wolfgang Baus
Georg Altenstein
Eric Beckers
Katrin Jurianz
Florian Sterzing
Matthias Kretschmer
Heinrich Seegenschmiedt
Torsten Maass
Stefan Droege
Ulrich Wolf
Juergen Schoeffler
Uwe Haverkamp
Hans Theodor Eich
Matthias Guckenberger
Publication date: 01-10-2017
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 10/2017
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-017-1151-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Planning benchmark study for SBRT of early stage NSCLC

Results of the DEGRO Working Group Stereotactic Radiotherapy

Abstract

Purpose

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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