TY - JOUR
T1 - Treatment planning for MR-guided SBRT of pancreatic tumors on a 1.5 T MR-Linac
T2 - A global consensus protocol
AU - Grimbergen, Guus
AU - Eijkelenkamp, Hidde
AU - Snoeren, Louk M.W.
AU - Bahij, Rana
AU - Bernchou, Uffe
AU - van der Bijl, Erik
AU - Heerkens, Hanne D.
AU - Binda, Shawn
AU - Ng, Sylvia S.W.
AU - Bouchart, Christelle
AU - Paquier, Zelda
AU - Brown, Kerryn
AU - Khor, Richard
AU - Chuter, Robert
AU - Freear, Linnéa
AU - Dunlop, Alex
AU - Mitchell, Robert Adam
AU - Erickson, Beth A.
AU - Hall, William A.
AU - Godoy Scripes, Paola
AU - Tyagi, Neelam
AU - de Leon, Jeremiah
AU - Tran, Charles
AU - Oh, Seungjong
AU - Renz, Paul
AU - Shessel, Andrea
AU - Taylor, Edward
AU - Intven, Martijn P.W.
AU - Meijer, Gert J.
N1 - Publisher Copyright:
© 2024 The Author(s)
PY - 2024/7
Y1 - 2024/7
N2 - Background and purpose: Treatment planning for MR-guided stereotactic body radiotherapy (SBRT) for pancreatic tumors can be challenging, leading to a wide variation of protocols and practices. This study aimed to harmonize treatment planning by developing a consensus planning protocol for MR-guided pancreas SBRT on a 1.5 T MR-Linac. Materials and methods: A consortium was founded of thirteen centers that treat pancreatic tumors on a 1.5 T MR-Linac. A phased planning exercise was conducted in which centers iteratively created treatment plans for two cases of pancreatic cancer. Each phase was followed by a meeting where the instructions for the next phase were determined. After three phases, a consensus protocol was reached. Results: In the benchmarking phase (phase I), substantial variation between the SBRT protocols became apparent (for example, the gross tumor volume (GTV) D99% ranged between 36.8 – 53.7 Gy for case 1, 22.6 – 35.5 Gy for case 2). The next phase involved planning according to the same basic dosimetric objectives, constraints, and planning margins (phase II), which led to a large degree of harmonization (GTV D99% range: 47.9–53.6 Gy for case 1, 33.9–36.6 Gy for case 2). In phase III, the final consensus protocol was formulated in a treatment planning system template and again used for treatment planning. This not only resulted in further dosimetric harmonization (GTV D99% range: 48.2–50.9 Gy for case 1, 33.5–36.0 Gy for case 2) but also in less variation of estimated treatment delivery times. Conclusion: A global consensus protocol has been developed for treatment planning for MR-guided pancreatic SBRT on a 1.5 T MR-Linac. Aside from harmonizing the large variation in the current clinical practice, this protocol can provide a starting point for centers that are planning to treat pancreatic tumors on MR-Linac systems.
AB - Background and purpose: Treatment planning for MR-guided stereotactic body radiotherapy (SBRT) for pancreatic tumors can be challenging, leading to a wide variation of protocols and practices. This study aimed to harmonize treatment planning by developing a consensus planning protocol for MR-guided pancreas SBRT on a 1.5 T MR-Linac. Materials and methods: A consortium was founded of thirteen centers that treat pancreatic tumors on a 1.5 T MR-Linac. A phased planning exercise was conducted in which centers iteratively created treatment plans for two cases of pancreatic cancer. Each phase was followed by a meeting where the instructions for the next phase were determined. After three phases, a consensus protocol was reached. Results: In the benchmarking phase (phase I), substantial variation between the SBRT protocols became apparent (for example, the gross tumor volume (GTV) D99% ranged between 36.8 – 53.7 Gy for case 1, 22.6 – 35.5 Gy for case 2). The next phase involved planning according to the same basic dosimetric objectives, constraints, and planning margins (phase II), which led to a large degree of harmonization (GTV D99% range: 47.9–53.6 Gy for case 1, 33.9–36.6 Gy for case 2). In phase III, the final consensus protocol was formulated in a treatment planning system template and again used for treatment planning. This not only resulted in further dosimetric harmonization (GTV D99% range: 48.2–50.9 Gy for case 1, 33.5–36.0 Gy for case 2) but also in less variation of estimated treatment delivery times. Conclusion: A global consensus protocol has been developed for treatment planning for MR-guided pancreatic SBRT on a 1.5 T MR-Linac. Aside from harmonizing the large variation in the current clinical practice, this protocol can provide a starting point for centers that are planning to treat pancreatic tumors on MR-Linac systems.
KW - Consensus protocol
KW - MR-guided SBRT
KW - Pancreatic cancer
KW - Treatment planning
UR - https://www.scopus.com/pages/publications/85193854752
U2 - 10.1016/j.ctro.2024.100797
DO - 10.1016/j.ctro.2024.100797
M3 - Article
C2 - 38831754
AN - SCOPUS:85193854752
SN - 2405-6308
VL - 47
JO - Clinical and Translational Radiation Oncology
JF - Clinical and Translational Radiation Oncology
M1 - 100797
ER -