Multi-institutional comparison of treatment planning using stereotactic ablative body radiotherapy for hepatocellular carcinoma - benchmark for a prospective multi-institutional study

Takahisa Eriguchi, Atsuya Takeda, Yohei Oku, Satoshi Ishikura, Tomoki Kimura, Shuichi Ozawa, Takeo Nakashima, Yukinori Matsuo, Mitsuhiro Nakamura, Yasuo Matsumoto, Sadanori Yamazaki, Naoko Sanuki, Yoshinori Ito

研究成果: Article

8 引用 (Scopus)

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Introduction: Several single institution phase I and phase II trials of stereotactic ablative body radiotherapy (SABR) for liver tumors have reported promising results and high local control rates of over 90%. However, there are wide variations in dose and fractionation due to different prescription policies and treatment methods across SABR series that have been published to date.This study aims to assess and minimize inter-institutional variations in treatment planning using SABR for hepatocellular carcinoma (HCC) in preparation for a prospective multi-institutional study.Methods: Four institutions (A-D) participated in this study. Each institution was provided with data from four cases, including planning and diagnostic CT images and clinical information, and asked to implement three plans (a practice plan and protocol plans 1 and 2). Practice plans were established based on the current treatment protocols at each institution. In protocol plan 1, each institution was instructed to prescribe 40 Gy in five fractions within 95% of the planning target volume (PTV). After protocol plan 1 was evaluated, we made protocol plan 2, The additional regulation to protocol plan 1 was that 40 Gy in five fractions was prescribed to a 70% isodose line of the global maximum dose within the PTV. Planning methods and dose volume histograms (DVHs) including the median PTV D50 (Dm50) and the median normal liver volume that received 20 Gy or higher (Vm20) were compared.Results: In the practice plan, Dm50 was 48.4 Gy (range, 43.6-51.2 Gy). Vm20 was 15.9% (range, 12.2-18.9%). In protocol plan 1, the Dm50 at institution A was higher (51.2 Gy) than the other institutions (42.0-42.2 Gy) due to differences in dose specifications. In protocol plan 2, variations in DVHs were reduced. The Dm50 was 51.9 Gy (range, 51.0-53.1 Gy), and the Vm20 was 12.3% (range, 10.4-13.2%). The homogeneity index was nearly equivalent at all institutions.Conclusions: There were notable inter-institutional differences in practice planning using SABR to treat HCC. The range of PTV and normal liver DVH values was reduced when the dose was prescribed to an isodose line within the PTV. In multi-institutional studies, detailed dose specifications based on collaboration are necessary.

元の言語English
記事番号113
ジャーナルRadiation Oncology
8
発行部数1
DOI
出版物ステータスPublished - 2013 5 4
外部発表Yes

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Benchmarking
Radiosurgery
Hepatocellular Carcinoma
Liver
Dose Fractionation
Therapeutics
Clinical Protocols
Prescriptions
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

これを引用

Multi-institutional comparison of treatment planning using stereotactic ablative body radiotherapy for hepatocellular carcinoma - benchmark for a prospective multi-institutional study. / Eriguchi, Takahisa; Takeda, Atsuya; Oku, Yohei; Ishikura, Satoshi; Kimura, Tomoki; Ozawa, Shuichi; Nakashima, Takeo; Matsuo, Yukinori; Nakamura, Mitsuhiro; Matsumoto, Yasuo; Yamazaki, Sadanori; Sanuki, Naoko; Ito, Yoshinori.

:: Radiation Oncology, 巻 8, 番号 1, 113, 04.05.2013.

研究成果: Article

Eriguchi, T, Takeda, A, Oku, Y, Ishikura, S, Kimura, T, Ozawa, S, Nakashima, T, Matsuo, Y, Nakamura, M, Matsumoto, Y, Yamazaki, S, Sanuki, N & Ito, Y 2013, 'Multi-institutional comparison of treatment planning using stereotactic ablative body radiotherapy for hepatocellular carcinoma - benchmark for a prospective multi-institutional study', Radiation Oncology, 巻. 8, 番号 1, 113. https://doi.org/10.1186/1748-717X-8-113
Eriguchi, Takahisa ; Takeda, Atsuya ; Oku, Yohei ; Ishikura, Satoshi ; Kimura, Tomoki ; Ozawa, Shuichi ; Nakashima, Takeo ; Matsuo, Yukinori ; Nakamura, Mitsuhiro ; Matsumoto, Yasuo ; Yamazaki, Sadanori ; Sanuki, Naoko ; Ito, Yoshinori. / Multi-institutional comparison of treatment planning using stereotactic ablative body radiotherapy for hepatocellular carcinoma - benchmark for a prospective multi-institutional study. :: Radiation Oncology. 2013 ; 巻 8, 番号 1.
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title = "Multi-institutional comparison of treatment planning using stereotactic ablative body radiotherapy for hepatocellular carcinoma - benchmark for a prospective multi-institutional study",
abstract = "Introduction: Several single institution phase I and phase II trials of stereotactic ablative body radiotherapy (SABR) for liver tumors have reported promising results and high local control rates of over 90{\%}. However, there are wide variations in dose and fractionation due to different prescription policies and treatment methods across SABR series that have been published to date.This study aims to assess and minimize inter-institutional variations in treatment planning using SABR for hepatocellular carcinoma (HCC) in preparation for a prospective multi-institutional study.Methods: Four institutions (A-D) participated in this study. Each institution was provided with data from four cases, including planning and diagnostic CT images and clinical information, and asked to implement three plans (a practice plan and protocol plans 1 and 2). Practice plans were established based on the current treatment protocols at each institution. In protocol plan 1, each institution was instructed to prescribe 40 Gy in five fractions within 95{\%} of the planning target volume (PTV). After protocol plan 1 was evaluated, we made protocol plan 2, The additional regulation to protocol plan 1 was that 40 Gy in five fractions was prescribed to a 70{\%} isodose line of the global maximum dose within the PTV. Planning methods and dose volume histograms (DVHs) including the median PTV D50 (Dm50) and the median normal liver volume that received 20 Gy or higher (Vm20) were compared.Results: In the practice plan, Dm50 was 48.4 Gy (range, 43.6-51.2 Gy). Vm20 was 15.9{\%} (range, 12.2-18.9{\%}). In protocol plan 1, the Dm50 at institution A was higher (51.2 Gy) than the other institutions (42.0-42.2 Gy) due to differences in dose specifications. In protocol plan 2, variations in DVHs were reduced. The Dm50 was 51.9 Gy (range, 51.0-53.1 Gy), and the Vm20 was 12.3{\%} (range, 10.4-13.2{\%}). The homogeneity index was nearly equivalent at all institutions.Conclusions: There were notable inter-institutional differences in practice planning using SABR to treat HCC. The range of PTV and normal liver DVH values was reduced when the dose was prescribed to an isodose line within the PTV. In multi-institutional studies, detailed dose specifications based on collaboration are necessary.",
keywords = "Benchmark, Clinical study, Hepatocellular carcinoma, SABR, SBRT, Stereotactic ablative body radiotherapy, Stereotactic body radiotherapy",
author = "Takahisa Eriguchi and Atsuya Takeda and Yohei Oku and Satoshi Ishikura and Tomoki Kimura and Shuichi Ozawa and Takeo Nakashima and Yukinori Matsuo and Mitsuhiro Nakamura and Yasuo Matsumoto and Sadanori Yamazaki and Naoko Sanuki and Yoshinori Ito",
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doi = "10.1186/1748-717X-8-113",
language = "English",
volume = "8",
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issn = "1748-717X",
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T1 - Multi-institutional comparison of treatment planning using stereotactic ablative body radiotherapy for hepatocellular carcinoma - benchmark for a prospective multi-institutional study

AU - Eriguchi, Takahisa

AU - Takeda, Atsuya

AU - Oku, Yohei

AU - Ishikura, Satoshi

AU - Kimura, Tomoki

AU - Ozawa, Shuichi

AU - Nakashima, Takeo

AU - Matsuo, Yukinori

AU - Nakamura, Mitsuhiro

AU - Matsumoto, Yasuo

AU - Yamazaki, Sadanori

AU - Sanuki, Naoko

AU - Ito, Yoshinori

PY - 2013/5/4

Y1 - 2013/5/4

N2 - Introduction: Several single institution phase I and phase II trials of stereotactic ablative body radiotherapy (SABR) for liver tumors have reported promising results and high local control rates of over 90%. However, there are wide variations in dose and fractionation due to different prescription policies and treatment methods across SABR series that have been published to date.This study aims to assess and minimize inter-institutional variations in treatment planning using SABR for hepatocellular carcinoma (HCC) in preparation for a prospective multi-institutional study.Methods: Four institutions (A-D) participated in this study. Each institution was provided with data from four cases, including planning and diagnostic CT images and clinical information, and asked to implement three plans (a practice plan and protocol plans 1 and 2). Practice plans were established based on the current treatment protocols at each institution. In protocol plan 1, each institution was instructed to prescribe 40 Gy in five fractions within 95% of the planning target volume (PTV). After protocol plan 1 was evaluated, we made protocol plan 2, The additional regulation to protocol plan 1 was that 40 Gy in five fractions was prescribed to a 70% isodose line of the global maximum dose within the PTV. Planning methods and dose volume histograms (DVHs) including the median PTV D50 (Dm50) and the median normal liver volume that received 20 Gy or higher (Vm20) were compared.Results: In the practice plan, Dm50 was 48.4 Gy (range, 43.6-51.2 Gy). Vm20 was 15.9% (range, 12.2-18.9%). In protocol plan 1, the Dm50 at institution A was higher (51.2 Gy) than the other institutions (42.0-42.2 Gy) due to differences in dose specifications. In protocol plan 2, variations in DVHs were reduced. The Dm50 was 51.9 Gy (range, 51.0-53.1 Gy), and the Vm20 was 12.3% (range, 10.4-13.2%). The homogeneity index was nearly equivalent at all institutions.Conclusions: There were notable inter-institutional differences in practice planning using SABR to treat HCC. The range of PTV and normal liver DVH values was reduced when the dose was prescribed to an isodose line within the PTV. In multi-institutional studies, detailed dose specifications based on collaboration are necessary.

AB - Introduction: Several single institution phase I and phase II trials of stereotactic ablative body radiotherapy (SABR) for liver tumors have reported promising results and high local control rates of over 90%. However, there are wide variations in dose and fractionation due to different prescription policies and treatment methods across SABR series that have been published to date.This study aims to assess and minimize inter-institutional variations in treatment planning using SABR for hepatocellular carcinoma (HCC) in preparation for a prospective multi-institutional study.Methods: Four institutions (A-D) participated in this study. Each institution was provided with data from four cases, including planning and diagnostic CT images and clinical information, and asked to implement three plans (a practice plan and protocol plans 1 and 2). Practice plans were established based on the current treatment protocols at each institution. In protocol plan 1, each institution was instructed to prescribe 40 Gy in five fractions within 95% of the planning target volume (PTV). After protocol plan 1 was evaluated, we made protocol plan 2, The additional regulation to protocol plan 1 was that 40 Gy in five fractions was prescribed to a 70% isodose line of the global maximum dose within the PTV. Planning methods and dose volume histograms (DVHs) including the median PTV D50 (Dm50) and the median normal liver volume that received 20 Gy or higher (Vm20) were compared.Results: In the practice plan, Dm50 was 48.4 Gy (range, 43.6-51.2 Gy). Vm20 was 15.9% (range, 12.2-18.9%). In protocol plan 1, the Dm50 at institution A was higher (51.2 Gy) than the other institutions (42.0-42.2 Gy) due to differences in dose specifications. In protocol plan 2, variations in DVHs were reduced. The Dm50 was 51.9 Gy (range, 51.0-53.1 Gy), and the Vm20 was 12.3% (range, 10.4-13.2%). The homogeneity index was nearly equivalent at all institutions.Conclusions: There were notable inter-institutional differences in practice planning using SABR to treat HCC. The range of PTV and normal liver DVH values was reduced when the dose was prescribed to an isodose line within the PTV. In multi-institutional studies, detailed dose specifications based on collaboration are necessary.

KW - Benchmark

KW - Clinical study

KW - Hepatocellular carcinoma

KW - SABR

KW - SBRT

KW - Stereotactic ablative body radiotherapy

KW - Stereotactic body radiotherapy

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