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Published in: Strahlentherapie und Onkologie 3/2019

01-03-2019 | Original Article

SBRT planning for spinal metastasis: indications from a large multicentric study

Authors: Marco Esposito, PhD, Laura Masi, Margherita Zani, Raffaela Doro, David Fedele, Cristina Garibaldi, Stefania Clemente, Christian Fiandra, Francesca Romana Giglioli, Carmelo Marino, Laura Orsingher, Serenella Russo, Michele Stasi, Lidia Strigari, Elena Villaggi, Pietro Mancosu

Published in: Strahlentherapie und Onkologie | Issue 3/2019

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Abstract

Background

The dosimetric variability in spine stereotactic body radiation therapy (SBRT) planning was investigated in a large number of centres to identify crowd knowledge-based solutions.

Methods

Two spinal cases were planned by 48 planners (38 centres). The required prescription dose (PD) was 3 × 10 Gy and the planning target volume (PTV) coverage request was: VPD > 90% (minimum request: VPD > 80%). The dose constraints were: planning risk volume (PRV) spinal cord: V18Gy < 0.35 cm3, V21.9 Gy < 0.03 cm3; oesophagus: V17.7 Gy < 5 cm3, V25.2 Gy < 0.03 cm3. Planners who did not fulfil the protocol requirements were asked to re-optimize the plans, using the results of planners with the same technology. Statistical analysis was performed to assess correlations between dosimetric results and planning parameters. A quality index (QI) was defined for scoring plans.

Results

In all, 12.5% of plans did not meet the protocol requirements. After re-optimization, 98% of plans fulfilled the constraints, showing the positive impact of knowledge sharing. Statistical analysis showed a significant correlation (p < 0.05) between the homogeneity index (HI) and PTV coverage for both cases, while the correlation between HI and spinal cord sparing was significant only for the single dorsal PTV case. Moreover, the multileaf collimator leaf thickness correlated with the spinal cord sparing. Planners using comparable delivery/planning system techniques produced different QI, highlighting the impact of the planner’s skills in the optimization process.

Conclusion

Both the technology and the planner’s skills are fundamentally important in spine SBRT planning optimization. Knowledge sharing helped to follow the plan objectives.
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Metadata
Title
SBRT planning for spinal metastasis: indications from a large multicentric study
Authors
Marco Esposito, PhD
Laura Masi
Margherita Zani
Raffaela Doro
David Fedele
Cristina Garibaldi
Stefania Clemente
Christian Fiandra
Francesca Romana Giglioli
Carmelo Marino
Laura Orsingher
Serenella Russo
Michele Stasi
Lidia Strigari
Elena Villaggi
Pietro Mancosu
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 3/2019
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-018-1383-2

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