TY - JOUR
T1 - Dose prescription for stereotactic body radiotherapy
T2 - general and organ-specific consensus statement from the DEGRO/DGMP Working Group Stereotactic Radiotherapy and Radiosurgery
AU - Brunner, Thomas B.
AU - Boda-Heggemann, Judit
AU - Buergy, Daniel
AU - Corradini, Stefanie
AU - Dieckmann, Ute Karin
AU - Gawish, Ahmed
AU - Gerum, Sabine
AU - Gkika, Eleni
AU - Grohmann, Maximilian
AU - Hoerner-Rieber, Juliane
AU - Kirste, Simon
AU - Klement, Rainer J.
AU - Moustakis, Christos
AU - Nestle, Ursula
AU - Niyazi, Maximilian
AU - Ruhle, Alexander
AU - Lang, Stephanie-Tanadini
AU - Winkler, Peter
AU - Zurl, Brigitte
AU - Wittig-Sauerwein, Andrea
AU - Blanck, Oliver
N1 - Gerum: Department of Radiation Oncology, Paracelsus University
Salzburg, Salzburg, Austria
PY - 2024/7/12
Y1 - 2024/7/12
N2 - Purpose and objective To develop expert consensus statements on multiparametric dose prescriptions for stereotactic body radiotherapy (SBRT) aligning with ICRU report 91. These statements serve as a foundational step towards harmonizing current SBRT practices and refining dose prescription and documentation requirements for clinical trial designs. Materials and methods Based on the results of a literature review by the working group, a two-tier Delphi consensus process was conducted among 24 physicians and physics experts from three European countries. The degree of consensus was predefined for overarching (OA) and organ-specific (OS) statements (>= 80%, 60-79%, < 60% for high, intermediate, and poor consensus, respectively). Post-first round statements were refined in a live discussion for the second round of the Delphi process. Results Experts consented on a total of 14 OA and 17 OS statements regarding SBRT of primary and secondary lung, liver, pancreatic, adrenal, and kidney tumors regarding dose prescription, target coverage, and organ at risk dose limitations. Degree of consent was >= 80% in 79% and 41% of OA and OS statements, respectively, with higher consensus for lung compared to the upper abdomen. In round 2, the degree of consent was >= 80 to 100% for OA and 88% in OS statements. No consensus was reached for dose escalation to liver metastases after chemotherapy (47%) or single-fraction SBRT for kidney primaries (13%). In round 2, no statement had 60-79% consensus. Conclusion In 29 of 31 statements a high consensus was achieved after a two-tier Delphi process and one statement (kidney) was clearly refused. The Delphi process was able to achieve a high degree of consensus for SBRT dose prescription. In summary, clear recommendations for both OA and OS could be defined. This contributes significantly to harmonization of SBRT practice and facilitates dose prescription and reporting in clinical trials investigating SBRT.
AB - Purpose and objective To develop expert consensus statements on multiparametric dose prescriptions for stereotactic body radiotherapy (SBRT) aligning with ICRU report 91. These statements serve as a foundational step towards harmonizing current SBRT practices and refining dose prescription and documentation requirements for clinical trial designs. Materials and methods Based on the results of a literature review by the working group, a two-tier Delphi consensus process was conducted among 24 physicians and physics experts from three European countries. The degree of consensus was predefined for overarching (OA) and organ-specific (OS) statements (>= 80%, 60-79%, < 60% for high, intermediate, and poor consensus, respectively). Post-first round statements were refined in a live discussion for the second round of the Delphi process. Results Experts consented on a total of 14 OA and 17 OS statements regarding SBRT of primary and secondary lung, liver, pancreatic, adrenal, and kidney tumors regarding dose prescription, target coverage, and organ at risk dose limitations. Degree of consent was >= 80% in 79% and 41% of OA and OS statements, respectively, with higher consensus for lung compared to the upper abdomen. In round 2, the degree of consent was >= 80 to 100% for OA and 88% in OS statements. No consensus was reached for dose escalation to liver metastases after chemotherapy (47%) or single-fraction SBRT for kidney primaries (13%). In round 2, no statement had 60-79% consensus. Conclusion In 29 of 31 statements a high consensus was achieved after a two-tier Delphi process and one statement (kidney) was clearly refused. The Delphi process was able to achieve a high degree of consensus for SBRT dose prescription. In summary, clear recommendations for both OA and OS could be defined. This contributes significantly to harmonization of SBRT practice and facilitates dose prescription and reporting in clinical trials investigating SBRT.
KW - Consensus
KW - Dose prescription
KW - ICRU report 91
KW - Radiation oncology
KW - Stereotactic body radiotherapy
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001271474400002&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1007/s00066-024-02254-2
DO - 10.1007/s00066-024-02254-2
M3 - Review article
C2 - 38997440
SN - 0179-7158
JO - STRAHLENTHERAPIE UND ONKOLOGIE
JF - STRAHLENTHERAPIE UND ONKOLOGIE
ER -