Planning Benchmark Study for Stereotactic Body Radiation Therapy of Pancreas Carcinomas With Simultaneously Integrated Boost and Protection: Results of the DEGRO/DGMP Working Group on Stereotactic Radiation Therapy and Radiosurgery
Year: 2024
Type: article
Abstract: Purpose/Objective The proximity or overlap of PTV and OAR poses a major challenge in SBRT of pancreatic cancer (PACA). This international treatment planning benchmark study investigates whether Simultaneously Integrated Boost (SIB) and Protection (SIP) concepts in PACA SBRT can lead to improved and harmonized plan quality. Materials/Methods A multiparametric specification of desired target doses (GTV D50% , GTV D99% , PTV D95% , PTV 0.5cc ) with two prescription doses of GTV D50% =5×9.2Gy (46Gy) and GTV D50% =8×8.25Gy (66Gy) and OAR limits were distributed with planning CT and contours from 3 PACA patients. In phase 1, plans were ranked using a scoring system for comparison of trade-offs between GTV/PTV and OAR. In phase 2, re-planning was performed for the most challenging case and prescription with dedicated SIB and SIP contours provided for optimization after group discussion. Results For all 3 cases and both phases combined, 292 plans were generated from 42 institutions in 5 countries using commonly available treatment planning systems. The GTV D50% prescription was performed by only 76% and 74% of planners within 2% for 5 and 8 fractions, respectively. The GTV D99% goal was mostly reached, while the balance between OAR and target dose showed initial SIB/SIP-like optimization strategies in about 50% of plans. For plan ranking, 149 and 217 score penalties were given for 5 and 8 fractions, pointing to improvement possibilities. For phase 2, the GTV D50% prescription was performed by 95% of planners within 2% and GTV D99% as well as OAR doses were better harmonized with notable less score penalties. Fourteen of 19 planners improved their plan rank, 9 of them by at least 2 ranks. Conclusion Dedicated SIB/SIP concepts in combination with multiparametric prescriptions and constraints can lead to overall harmonized and high treatment plan quality for PACA SBRT. Standardized SIB/SIP treatment planning in multicenter clinical trials appears feasible after group consensus and training.
Authors: Christos Moustakis, Oliver Blanck, Maximilian Grohmann, Dirk Albers, Dennis Bartels, Bastian Bathen, Giuseppina Rita Borzì, Sara Broggi, Andrea Bruschi, Michelina Casale, Anna Delana, Paul Doolan, Fatemeh Ebrahimi Tazehmahalleh, Stefania Fabiani, Maria Daniela Falco, Roman Fehr, Melissa Friedlein, Susanne Gutser, Abdul Malek Hamada, Timothy Hancock, Janett Köhn, Christine Kornhuber, Thomas Krieger, Ulrike Lambrecht, Sara Lappi, Eugenia Moretti, Annalena Mirus, Thomas Muedder, Sandija Plaude, Bernd Polvika, Valentina Ravaglia, Roberto Righetto, Giuseppe Rinaldin, Henrik Schachner, Alessandro Scaggion, Philipp Schilling, Philipp Szeverinski, Elena Villaggi, Mathias Walke, Lotte Wilke, Peter Winkler, Nils H. Nicolay, Hans Theodor Eich, Eleni Gkika, Thomas B. Brunner, Daniela Schmitt
Institutions: University Hospital Münster, University Hospital Leipzig, University Hospital Schleswig-Holstein, SAPHIR Radiochirurgie, University Medical Center Hamburg-Eppendorf, Goethe University Frankfurt, University Hospital Frankfurt, IRCCS Ospedale San Raffaele, Casa di cura Pierangeli, Casa di Cura Città di Roma, Azienda Ospedaliera S.Maria, Ospedale Santa Chiara, Helios Hospital Schwerin, University Hospital Cologne, University of Chieti-Pescara, Ospedale SS. Annunziata, Universitätsmedizin Rostock, University of Rostock, Jena University Hospital, University Hospital Augsburg, Kantonsspital Aarau, University Hospital in Halle, University of Würzburg, Universitätsklinikum Würzburg, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsklinikum Erlangen, Azienda sanitaria universitaria Friuli Centrale, Charité - Universitätsmedizin Berlin, University of Bonn, University Hospital Bonn, Kantonsspital Graubünden, Provincia Autonoma di Trento, AULSS 2 Marca Trevigiana, Istituto Oncologico Veneto, Krankenhaus Dresden-Friedrichstadt, Landeskrankenhaus Feldkirch, Azienda Unità Sanitaria Locale Piacenza, University Hospital Magdeburg, University Hospital Zurich, Medical University of Graz, University of Freiburg, University Medical Center Freiburg, Universitätsmedizin Göttingen, University of Göttingen
Language: English
Subfield: Radiation
Field: Physics and Astronomy
Domain: Physical Sciences
Open Access status: hybrid
Estimated APC paid: $3,940
OpenAlex ID: W4402115655