美国质子治疗中心前列腺立体定向体放射治疗的现状与挑战:NRG 肿瘤学实践调查。

IF 2.1 Q3 ONCOLOGY International Journal of Particle Therapy Pub Date : 2024-04-24 eCollection Date: 2024-03-01 DOI:10.1016/j.ijpt.2024.100020
Jiajian Shen, Paige A Taylor, Carlos E Vargas, Minglei Kang, Jatinder Saini, Jun Zhou, Peilong Wang, Wei Liu, Charles B Simone, Ying Xiao, Liyong Lin
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引用次数: 0

摘要

目的:报告目前质子立体定向体放射治疗(SBRT)治疗前列腺癌的实践模式:设计了一项调查,以了解质子 SBRT 治疗前列腺癌的实践情况。调查表于 2023 年 2 月分发给美国参加国家临床试验网络的所有 30 个质子治疗中心。调查的重点包括使用情况、患者选择标准、处方、靶轮廓、剂量限制、治疗方案优化和评估方法、患者特异性质量保证以及图像引导放射治疗(IGRT)方法:我们收到了来自 25 个中心(83% 参与)的回复。只有 8 家质子中心(32%)报告对前列腺进行了 SBRT 治疗。其余 17 个中心列举了不提供这种治疗的 3 个主要原因:无临床需求、缺乏容积成像和/或缺乏临床证据。只有 1 家中心认为,不提供前列腺 SBRT 治疗的原因是总体报销额度减少。在提供前列腺 SBRT 治疗的 8 家中心中,有几种常见的做法,如使用水凝胶垫片、靶标和磁共振成像(MRI)进行靶区划分。大多数质子中心(87.5%)使用铅笔束扫描(PBS)传输,并完成了成像与放射肿瘤学核心(IROC)的人体模型认证。治疗计划通常使用平行对侧射束,并将一致的设置参数和范围不确定性用于计划优化和稳健性评估。以测量为基础的患者特异性质量保证、隔天一次的射束传输、IGRT 的靶点轮廓以及 35 至 40 GyRBE 的总剂量在所有中心都是一致的。但是,对于选择患者的风险水平,各中心并没有达成共识:结论:美国约有 1/3 的质子中心使用前列腺 SBRT。采用质子 SBRT 治疗的质子中心在做法上有很大的一致性。如果质子 SBRT 在临床试验中得到更广泛的应用,质子 SBRT 的应用可能会变得更加普遍。
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The Status and Challenges for Prostate Stereotactic Body Radiation Therapy Treatments in United States Proton Therapy Centers: An NRG Oncology Practice Survey.

Purpose: To report the current practice pattern of the proton stereotactic body radiation therapy (SBRT) for prostate treatments.

Materials and methods: A survey was designed to inquire about the practice of proton SBRT treatment for prostate cancer. The survey was distributed to all 30 proton therapy centers in the United States that participate in the National Clinical Trial Network in February, 2023. The survey focused on usage, patient selection criteria, prescriptions, target contours, dose constraints, treatment plan optimization and evaluation methods, patient-specific QA, and image-guided radiation therapy (IGRT) methods.

Results: We received responses from 25 centers (83% participation). Only 8 respondent proton centers (32%) reported performing SBRT of the prostate. The remaining 17 centers cited 3 primary reasons for not offering this treatment: no clinical need, lack of volumetric imaging, and/or lack of clinical evidence. Only 1 center cited the reduction in overall reimbursement as a concern for not offering prostate SBRT. Several common practices among the 8 centers offering SBRT for the prostate were noted, such as using Hydrogel spacers, fiducial markers, and magnetic resonance imaging (MRI) for target delineation. Most proton centers (87.5%) utilized pencil beam scanning (PBS) delivery and completed Imaging and Radiation Oncology Core (IROC) phantom credentialing. Treatment planning typically used parallel opposed lateral beams, and consistent parameters for setup and range uncertainties were used for plan optimization and robustness evaluation. Measurements-based patient-specific QA, beam delivery every other day, fiducial contours for IGRT, and total doses of 35 to 40 GyRBE were consistent across all centers. However, there was no consensus on the risk levels for patient selection.

Conclusion: Prostate SBRT is used in about 1/3 of proton centers in the US. There was a significant consistency in practices among proton centers treating with proton SBRT. It is possible that the adoption of proton SBRT may become more common if proton SBRT is more commonly offered in clinical trials.

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来源期刊
International Journal of Particle Therapy
International Journal of Particle Therapy Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
3.70
自引率
5.90%
发文量
23
审稿时长
20 weeks
期刊最新文献
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