Thomas B Brunner, Judit Boda-Heggemann, Daniel Bürgy, Stefanie Corradini, Ute Karin Dieckmann, Ahmed Gawish, Sabine Gerum, Eleni Gkika, Maximilian Grohmann, Juliane Hörner-Rieber, Simon Kirste, Rainer J Klement, Christos Moustakis, Ursula Nestle, Maximilian Niyazi, Alexander Rühle, Stephanie-Tanadini Lang, Peter Winkler, Brigitte Zurl, Andrea Wittig-Sauerwein, Oliver Blanck
{"title":"立体定向体放射治疗剂量处方：DEGRO/DGMP 立体定向放射治疗和放射外科工作组的一般和特定器官共识声明。","authors":"Thomas B Brunner, Judit Boda-Heggemann, Daniel Bürgy, Stefanie Corradini, Ute Karin Dieckmann, Ahmed Gawish, Sabine Gerum, Eleni Gkika, Maximilian Grohmann, Juliane Hörner-Rieber, Simon Kirste, Rainer J Klement, Christos Moustakis, Ursula Nestle, Maximilian Niyazi, Alexander Rühle, Stephanie-Tanadini Lang, Peter Winkler, Brigitte Zurl, Andrea Wittig-Sauerwein, Oliver Blanck","doi":"10.1007/s00066-024-02254-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose and objective: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":21998,"journal":{"name":"Strahlentherapie und Onkologie","volume":" ","pages":"737-750"},"PeriodicalIF":2.7000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343978/pdf/","citationCount":"0","resultStr":"{\"title\":\"Dose prescription for stereotactic body radiotherapy: general and organ-specific consensus statement from the DEGRO/DGMP Working Group Stereotactic Radiotherapy and Radiosurgery.\",\"authors\":\"Thomas B Brunner, Judit Boda-Heggemann, Daniel Bürgy, Stefanie Corradini, Ute Karin Dieckmann, Ahmed Gawish, Sabine Gerum, Eleni Gkika, Maximilian Grohmann, Juliane Hörner-Rieber, Simon Kirste, Rainer J Klement, Christos Moustakis, Ursula Nestle, Maximilian Niyazi, Alexander Rühle, Stephanie-Tanadini Lang, Peter Winkler, Brigitte Zurl, Andrea Wittig-Sauerwein, Oliver Blanck\",\"doi\":\"10.1007/s00066-024-02254-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose and objective: </strong>To develop expert consensus statements on multiparametric dose prescriptions for stereotactic body radiotherapy (SBRT) aligning with ICRU report 91. 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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.</p><p><strong>Conclusion: </strong>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. 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引用次数: 0
摘要
目的和目标：根据ICRU第91号报告，制定立体定向体外放射治疗（SBRT）多参数剂量处方的专家共识声明。这些声明是协调当前 SBRT 实践、完善剂量处方和临床试验设计文件要求的基础性步骤：根据工作组的文献综述结果，对来自三个欧洲国家的 24 名医生和物理专家进行了两级德尔菲共识程序。预先确定了总体（OA）和器官特异性（OS）声明的共识程度（≥ 80%，60-79%，结果：专家们就原发性和继发性肺癌、肝癌、胰腺癌、肾上腺肿瘤和肾脏肿瘤的 SBRT 的剂量处方、靶点覆盖和高危器官剂量限制等问题，共达成了 14 项 OA 和 17 项 OS 声明。分别有 79% 和 41% 的 OA 和 OS 声明的同意程度≥ 80%，与上腹部相比，肺部的同意程度更高。在第二轮中，OA 和 OS 声明的同意程度≥ 80% 至 100%，OS 声明的同意程度为 88%。对于化疗后肝转移灶的剂量升级（47%）或肾脏原发灶的单分次SBRT（13%）未达成共识。在第二轮中，没有一项声明的共识率达到 60-79%：结论：31 项声明中有 29 项经过两级德尔菲程序达成了高度共识，有一项声明（肾脏）遭到明确拒绝。德尔菲过程能够就 SBRT 剂量处方达成高度共识。总之，针对 OA 和 OS 的明确建议得以确定。这极大地促进了 SBRT 实践的统一，并有助于 SBRT 临床试验中的剂量处方和报告。
Dose prescription for stereotactic body radiotherapy: general and organ-specific consensus statement from the DEGRO/DGMP Working Group Stereotactic Radiotherapy and Radiosurgery.
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.
期刊介绍：
Strahlentherapie und Onkologie, published monthly, is a scientific journal that covers all aspects of oncology with focus on radiooncology, radiation biology and radiation physics. The articles are not only of interest to radiooncologists but to all physicians interested in oncology, to radiation biologists and radiation physicists. The journal publishes original articles, review articles and case studies that are peer-reviewed. It includes scientific short communications as well as a literature review with annotated articles that inform the reader on new developments in the various disciplines concerned and hence allow for a sound overview on the latest results in radiooncology research.
Founded in 1912, Strahlentherapie und Onkologie is the oldest oncological journal in the world. Today, contributions are published in English and German. All articles have English summaries and legends. The journal is the official publication of several scientific radiooncological societies and publishes the relevant communications of these societies.
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