Andrew Oar1, Mark Lee2, Hien Le3, George Hruby4, Raymond Dalfsen3, David Pryor5, Dominique Lee5, Julie Chu6, Lois Holloway7, Adam Briggs8, Andrew Barbour9, Sarat Chander6, Sweet Ping Ng6, Jas Samra4, John Shakeshaft2, David Goldstein10, Nam Nguyen11, Karyn A Goodman12, Daniel T Chang13, Andrew Kneebone4. 1. Icon Cancer Centre, Gold Coast University Hospital, Gold Coast; Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia. Electronic address: andrew.oar@icon.team. 2. Icon Cancer Centre, Gold Coast University Hospital, Gold Coast. 3. Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, Australia. 4. Royal North Shore Hospital, Sydney, Australia; University of Sydney, Sydney, Australia. 5. Princess Alexandra Hospital, Brisbane, Australia. 6. Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. 7. Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia; South Western Clinical School, University of New South Wales, Sydney, Australia; Institute of Medical Physics, University of Sydney, Sydney, Australia; Centre for Medical Radiation Physics, University of Wollongong, Wollongong, Australia. 8. Royal North Shore Hospital, Sydney, Australia. 9. Princess Alexandra Hospital, Brisbane, Australia; University of Queensland, Diamantina Institute, Translational Research Institute, Woolloongabba, Australia. 10. Department of Medical Oncology, Nelune Cancer Centre, Prince of Wales Hospital, Sydney, Australia; Prince of Wales Clinical School, University of New South Wales, Sydney, Australia. 11. Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Discipline of Medicine, University of Adelaide, Adelaide, Australia. 12. Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado. 13. Stanford Cancer Institute, Stanford, California.
Abstract
PURPOSE: Nonrandomized data exploring pancreas stereotactic body radiation therapy (SBRT) has demonstrated excellent local control rates and low toxicity. Before commencing a randomized trial investigating pancreas SBRT, standardization of prescription dose, dose constraints, simulation technique, and clinical target volume delineation are required. METHODS AND MATERIALS: Specialists in radiation oncology, medical oncology, hepatobiliary surgery, and gastroenterology attended 2 consecutive Australasian Gastrointestinal Trials Group workshops in 2017 and 2018. Sample cases were discussed during workshop contact with specifically invited international speakers highly experienced in pancreas SBRT. Furthermore, sample cases were contoured and planned between workshop contact to finalize dose constraints and clinical target volume delineation. RESULTS: Over 2 separate workshops, consensus was reached on dose and simulation technique. The working group recommended a dose prescription of 40 Gy in 5 fractions. Treatment delivery during end-expiratory breath hold with triple-phase contrast enhanced computed tomography was recommended. In addition, dose constraints, stepwise contouring guidelines, and an anatomic atlas for pancreatic SBRT were developed. CONCLUSIONS: Pancreas SBRT is emerging as a promising treatment modality requiring prospective evaluation in randomized studies. This work attempts to standardize dose, simulation technique, and volume delineation to support the delivery of high quality SBRT in a multicenter study.
PURPOSE: Nonrandomized data exploring pancreas stereotactic body radiation therapy (SBRT) has demonstrated excellent local control rates and low toxicity. Before commencing a randomized trial investigating pancreas SBRT, standardization of prescription dose, dose constraints, simulation technique, and clinical target volume delineation are required. METHODS AND MATERIALS: Specialists in radiation oncology, medical oncology, hepatobiliary surgery, and gastroenterology attended 2 consecutive Australasian Gastrointestinal Trials Group workshops in 2017 and 2018. Sample cases were discussed during workshop contact with specifically invited international speakers highly experienced in pancreas SBRT. Furthermore, sample cases were contoured and planned between workshop contact to finalize dose constraints and clinical target volume delineation. RESULTS: Over 2 separate workshops, consensus was reached on dose and simulation technique. The working group recommended a dose prescription of 40 Gy in 5 fractions. Treatment delivery during end-expiratory breath hold with triple-phase contrast enhanced computed tomography was recommended. In addition, dose constraints, stepwise contouring guidelines, and an anatomic atlas for pancreatic SBRT were developed. CONCLUSIONS: Pancreas SBRT is emerging as a promising treatment modality requiring prospective evaluation in randomized studies. This work attempts to standardize dose, simulation technique, and volume delineation to support the delivery of high quality SBRT in a multicenter study.
Authors: Abhinav V Reddy; Colin S Hill; Shuchi Sehgal; Jin He; Lei Zheng; Joseph M Herman; Jeffrey Meyer; Amol K Narang Journal: J Gastrointest Oncol Date: 2022-06
Authors: Abhinav V Reddy; Colin S Hill; Shuchi Sehgal; Lei Zheng; Jin He; Daniel A Laheru; Ana De Jesus-Acosta; Joseph M Herman; Jeffrey Meyer; Amol K Narang Journal: Radiat Oncol J Date: 2022-05-20
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Authors: Abhinav V Reddy; Matthew P Deek; Juan F Jackson; Colin S Hill; Shuchi Sehgal; Jin He; Lei Zheng; Joseph M Herman; Jeffrey Meyer; Amol K Narang Journal: Radiat Oncol Date: 2021-12-24 Impact factor: 3.481