SBRT-Planung bei Wirbelsäulenmetastasen: Indikationen aus einer großen Multizenterstudie.

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 ...

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Published in:Strahlentherapie und Onkologie Vol. 195; no. 3; pp. 226 - 236
Main Authors: Esposito, Marco, Masi, Laura, Zani, Margherita, Doro, Raffaela, Fedele, David, Garibaldi, Cristina, Clemente, Stefania, Fiandra, Christian, Giglioli, Francesca Romana, Marino, Carmelo, Orsingher, Laura, Russo, Serenella, Stasi, Michele, Strigari, Lidia, Villaggi, Elena, Mancosu, Pietro
Format: research Journal Article
Published: Springer Nature Mar2019
Online Access:View this record in EBSCOhost
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      dt: Mar2019
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      pub: Springer Nature
      place: New York, New York
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        atl: SBRT-Planung bei Wirbelsäulenmetastasen: Indikationen aus einer großen Multizenterstudie.
      aug:
        au:
          Esposito, Marco
          Masi, Laura
          Zani, Margherita
          Doro, Raffaela
          Fedele, David
          Garibaldi, Cristina
          Clemente, Stefania
          Fiandra, Christian
          Giglioli, Francesca Romana
          Marino, Carmelo
          Orsingher, Laura
          Russo, Serenella
          Stasi, Michele
          Strigari, Lidia
          Villaggi, Elena
          Mancosu, Pietro
        affil: Medical Physics Complex Unit, Azienda USL Toscana Centro, Via dell'Antella 58, 50012, Bagno a Ripoli, Italy
      sug:
        subj:
          Radiotherapy, Computer-Assisted Methods
          Radiotherapy, Conformal Methods
          Radiometry
          Spinal Neoplasms
          Spinal Neoplasms Radiotherapy
          Radiosurgery Methods
          Human
          Spinal Cord Radiation Effects
          Body Regions Radiation Effects
          Clinical Competence
          Quality Assurance Methods
          Radiation Injuries Prevention and Control
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Ferrans and Powers Quality of Life Index
          Impact of Events Scale
      ab: 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.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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