LITE SABR M1: Planning design and dosimetric endpoints for a phase I trial of lattice SBRT

医学 核医学 放射治疗计划 SABR波动模型 放射治疗 人口 临床试验 医学物理学 放射科 数学 内科学 随机波动 波动性(金融) 环境卫生 计量经济学
作者
James Kavanaugh,Matthew B. Spraker,Sai Duriseti,Franco Basarabescu,Alex Price,Murty Goddu,Nels Knutson,Michael T. Prusator,Clifford G. Robinson,Thomas R. Mazur
出处
期刊:Radiotherapy and Oncology [Elsevier BV]
卷期号:167: 172-178 被引量:13
标识
DOI:10.1016/j.radonc.2021.12.003
摘要

Purpose Lattice stereotactic body radiation therapy (SBRT) is a form of spatially fractionated radiation therapy (SFRT) using SBRT methods. This study reports clinical dosimetric endpoints achieved for Lattice SBRT plans delivering 20 Gy in 5 fractions to the periphery of a tumor with a simultaneous integrated boost (SIB) of 66.7 Gy, as part of a prospective Phase I clinical trial (NCT04133415). Additionally, it updates previously reported planning and delivery techniques based on extended experience with a broader patient population. Methods Patients were enrolled on a single-arm phase I trial conducted between November 2019 and August 2020. Eligibility was restricted to tumors >4.5 cm in the largest dimension. Characteristic SFRT dose gradients were achieved using a lattice of 1.5 cm diameter spheres spaced within the GTV in a regular pattern, with peak-to-valley dose varying from 66.7 Gy to 20 Gy within 1.5 cm. Organ-at-risk (OAR) sparing followed AAPM TG101 recommendations for 5-fraction SBRT. Results Twenty patients (22 plans) were enrolled on study, with one additional plan treated off study. All OAR and target coverage planning objectives were achieved, with the exception of a single small bronchus. Conformity of the 20 Gy isodose line significantly improved over the course of the study. The majority (85.2%) of treatment fractions were delivered in a 30 minutes timeslot, with 4 (3.5%) exceeding a total treatment time of 40 minutes. Conclusion Lattice SBRT planning techniques produce consistent and efficient treatment plans. Refined techniques described here further improve the quality of the planning technique.
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