Lung stereotactic ablative body radiotherapy: A large scale multi-institutional planning comparison for interpreting results of multi-institutional studies

Francesca Giglioli, Lidia Strigari, R. Ragona, Giuseppina R. Borzì, Elisabetta Cagni, Claudia Carbonini, Stefania Clemente, Rita Consorti, Randa El Gawhary, Marco Esposito, Maria Daniela Falco, David Fedele, Christian Fiandra, Maria Cristina Frassanito, Valeria Landoni, Gianfranco Loi, Elena Lorenzini, Maria Rosa Malisan, Carmelo Marino, Enrico MenghiBarbara Nardiello, Roberta Nigro, Caterina Oliviero, Gabriella Pastore, Mariagrazia Quattrocchi, Ruggero Ruggieri, I. Redaelli, Giacomo Reggiori, Serenella Russo, Elena Villaggi, Marta Casati, Pietro Mancosu

Research output: Contribution to journalArticle

Abstract

Purpose: A large-scale multi-institutional planning comparison on lung cancer SABR is presented with the aim of investigating possible criticism in carrying out retrospective multicentre data analysis from a dosimetric perspective. Methods: Five CT series were sent to the participants. The dose prescription to PTV was 54 Gy in 3 fractions of 18 Gy. The plans were compared in terms of PTV-gEUD2 (generalized Equivalent Uniform Dose equivalent to 2 Gy), mean dose to PTV, Homogeneity Index (PTV-HI), Conformity Index (PTV-CI) and Gradient Index (PTV-GI). We calculated the maximum dose for each OAR (organ at risk) considered as well as the MLD2 (mean lung dose equivalent to 2 Gy). The data were stratified according to expertise and technology. Results: Twenty-six centers equipped with Linacs, 3DCRT (4% - 1 center), static IMRT (8% - 2 centers), VMAT (76% - 20 centers), CyberKnife (4% - 1 center), and Tomotherapy (8% - 2 centers) collaborated. Significant PTV-gEUD2 differences were observed (range: 105-161 Gy); mean-PTV dose, PTV-HI, PTV-CI, and PTV-GI were, respectively, 56.8 ± 3.4 Gy, 14.2 ± 10.1%, 0.70 ± 0.15, and 4.9 ± 1.9. Significant correlations for PTV-gEUD2 versus PTV-HI, and MLD2 versus PTV-GI, were observed. Conclusions: The differences in terms of PTV-gEUD2 may suggest the inclusion of PTV-gEUD2 calculation for retrospective data inter-comparison.

Original languageEnglish
Pages (from-to)600-606
Number of pages7
JournalPhysica Medica
Volume32
Issue number4
DOIs
Publication statusPublished - Apr 1 2016

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Organs at Risk
Radiosurgery
lungs
Prescriptions
planning
radiation therapy
Lung Neoplasms
Technology
Lung
dosage
homogeneity
gradients
organs
cancer
inclusions

Keywords

  • Dosimetry
  • Lung
  • Multicentric clinical trial
  • Radiobiology
  • Stereotactic ablative radiotherapy (SABR)
  • Stereotactic body radiation therapy (SBRT)

ASJC Scopus subject areas

  • Biophysics
  • Radiology Nuclear Medicine and imaging
  • Physics and Astronomy(all)

Cite this

Lung stereotactic ablative body radiotherapy : A large scale multi-institutional planning comparison for interpreting results of multi-institutional studies. / Giglioli, Francesca; Strigari, Lidia; Ragona, R.; Borzì, Giuseppina R.; Cagni, Elisabetta; Carbonini, Claudia; Clemente, Stefania; Consorti, Rita; El Gawhary, Randa; Esposito, Marco; Falco, Maria Daniela; Fedele, David; Fiandra, Christian; Frassanito, Maria Cristina; Landoni, Valeria; Loi, Gianfranco; Lorenzini, Elena; Malisan, Maria Rosa; Marino, Carmelo; Menghi, Enrico; Nardiello, Barbara; Nigro, Roberta; Oliviero, Caterina; Pastore, Gabriella; Quattrocchi, Mariagrazia; Ruggieri, Ruggero; Redaelli, I.; Reggiori, Giacomo; Russo, Serenella; Villaggi, Elena; Casati, Marta; Mancosu, Pietro.

In: Physica Medica, Vol. 32, No. 4, 01.04.2016, p. 600-606.

Research output: Contribution to journalArticle

Giglioli, F, Strigari, L, Ragona, R, Borzì, GR, Cagni, E, Carbonini, C, Clemente, S, Consorti, R, El Gawhary, R, Esposito, M, Falco, MD, Fedele, D, Fiandra, C, Frassanito, MC, Landoni, V, Loi, G, Lorenzini, E, Malisan, MR, Marino, C, Menghi, E, Nardiello, B, Nigro, R, Oliviero, C, Pastore, G, Quattrocchi, M, Ruggieri, R, Redaelli, I, Reggiori, G, Russo, S, Villaggi, E, Casati, M & Mancosu, P 2016, 'Lung stereotactic ablative body radiotherapy: A large scale multi-institutional planning comparison for interpreting results of multi-institutional studies', Physica Medica, vol. 32, no. 4, pp. 600-606. https://doi.org/10.1016/j.ejmp.2016.03.015
Giglioli, Francesca ; Strigari, Lidia ; Ragona, R. ; Borzì, Giuseppina R. ; Cagni, Elisabetta ; Carbonini, Claudia ; Clemente, Stefania ; Consorti, Rita ; El Gawhary, Randa ; Esposito, Marco ; Falco, Maria Daniela ; Fedele, David ; Fiandra, Christian ; Frassanito, Maria Cristina ; Landoni, Valeria ; Loi, Gianfranco ; Lorenzini, Elena ; Malisan, Maria Rosa ; Marino, Carmelo ; Menghi, Enrico ; Nardiello, Barbara ; Nigro, Roberta ; Oliviero, Caterina ; Pastore, Gabriella ; Quattrocchi, Mariagrazia ; Ruggieri, Ruggero ; Redaelli, I. ; Reggiori, Giacomo ; Russo, Serenella ; Villaggi, Elena ; Casati, Marta ; Mancosu, Pietro. / Lung stereotactic ablative body radiotherapy : A large scale multi-institutional planning comparison for interpreting results of multi-institutional studies. In: Physica Medica. 2016 ; Vol. 32, No. 4. pp. 600-606.
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abstract = "Purpose: A large-scale multi-institutional planning comparison on lung cancer SABR is presented with the aim of investigating possible criticism in carrying out retrospective multicentre data analysis from a dosimetric perspective. Methods: Five CT series were sent to the participants. The dose prescription to PTV was 54 Gy in 3 fractions of 18 Gy. The plans were compared in terms of PTV-gEUD2 (generalized Equivalent Uniform Dose equivalent to 2 Gy), mean dose to PTV, Homogeneity Index (PTV-HI), Conformity Index (PTV-CI) and Gradient Index (PTV-GI). We calculated the maximum dose for each OAR (organ at risk) considered as well as the MLD2 (mean lung dose equivalent to 2 Gy). The data were stratified according to expertise and technology. Results: Twenty-six centers equipped with Linacs, 3DCRT (4{\%} - 1 center), static IMRT (8{\%} - 2 centers), VMAT (76{\%} - 20 centers), CyberKnife (4{\%} - 1 center), and Tomotherapy (8{\%} - 2 centers) collaborated. Significant PTV-gEUD2 differences were observed (range: 105-161 Gy); mean-PTV dose, PTV-HI, PTV-CI, and PTV-GI were, respectively, 56.8 ± 3.4 Gy, 14.2 ± 10.1{\%}, 0.70 ± 0.15, and 4.9 ± 1.9. Significant correlations for PTV-gEUD2 versus PTV-HI, and MLD2 versus PTV-GI, were observed. Conclusions: The differences in terms of PTV-gEUD2 may suggest the inclusion of PTV-gEUD2 calculation for retrospective data inter-comparison.",
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T1 - Lung stereotactic ablative body radiotherapy

T2 - A large scale multi-institutional planning comparison for interpreting results of multi-institutional studies

AU - Giglioli, Francesca

AU - Strigari, Lidia

AU - Ragona, R.

AU - Borzì, Giuseppina R.

AU - Cagni, Elisabetta

AU - Carbonini, Claudia

AU - Clemente, Stefania

AU - Consorti, Rita

AU - El Gawhary, Randa

AU - Esposito, Marco

AU - Falco, Maria Daniela

AU - Fedele, David

AU - Fiandra, Christian

AU - Frassanito, Maria Cristina

AU - Landoni, Valeria

AU - Loi, Gianfranco

AU - Lorenzini, Elena

AU - Malisan, Maria Rosa

AU - Marino, Carmelo

AU - Menghi, Enrico

AU - Nardiello, Barbara

AU - Nigro, Roberta

AU - Oliviero, Caterina

AU - Pastore, Gabriella

AU - Quattrocchi, Mariagrazia

AU - Ruggieri, Ruggero

AU - Redaelli, I.

AU - Reggiori, Giacomo

AU - Russo, Serenella

AU - Villaggi, Elena

AU - Casati, Marta

AU - Mancosu, Pietro

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Purpose: A large-scale multi-institutional planning comparison on lung cancer SABR is presented with the aim of investigating possible criticism in carrying out retrospective multicentre data analysis from a dosimetric perspective. Methods: Five CT series were sent to the participants. The dose prescription to PTV was 54 Gy in 3 fractions of 18 Gy. The plans were compared in terms of PTV-gEUD2 (generalized Equivalent Uniform Dose equivalent to 2 Gy), mean dose to PTV, Homogeneity Index (PTV-HI), Conformity Index (PTV-CI) and Gradient Index (PTV-GI). We calculated the maximum dose for each OAR (organ at risk) considered as well as the MLD2 (mean lung dose equivalent to 2 Gy). The data were stratified according to expertise and technology. Results: Twenty-six centers equipped with Linacs, 3DCRT (4% - 1 center), static IMRT (8% - 2 centers), VMAT (76% - 20 centers), CyberKnife (4% - 1 center), and Tomotherapy (8% - 2 centers) collaborated. Significant PTV-gEUD2 differences were observed (range: 105-161 Gy); mean-PTV dose, PTV-HI, PTV-CI, and PTV-GI were, respectively, 56.8 ± 3.4 Gy, 14.2 ± 10.1%, 0.70 ± 0.15, and 4.9 ± 1.9. Significant correlations for PTV-gEUD2 versus PTV-HI, and MLD2 versus PTV-GI, were observed. Conclusions: The differences in terms of PTV-gEUD2 may suggest the inclusion of PTV-gEUD2 calculation for retrospective data inter-comparison.

AB - Purpose: A large-scale multi-institutional planning comparison on lung cancer SABR is presented with the aim of investigating possible criticism in carrying out retrospective multicentre data analysis from a dosimetric perspective. Methods: Five CT series were sent to the participants. The dose prescription to PTV was 54 Gy in 3 fractions of 18 Gy. The plans were compared in terms of PTV-gEUD2 (generalized Equivalent Uniform Dose equivalent to 2 Gy), mean dose to PTV, Homogeneity Index (PTV-HI), Conformity Index (PTV-CI) and Gradient Index (PTV-GI). We calculated the maximum dose for each OAR (organ at risk) considered as well as the MLD2 (mean lung dose equivalent to 2 Gy). The data were stratified according to expertise and technology. Results: Twenty-six centers equipped with Linacs, 3DCRT (4% - 1 center), static IMRT (8% - 2 centers), VMAT (76% - 20 centers), CyberKnife (4% - 1 center), and Tomotherapy (8% - 2 centers) collaborated. Significant PTV-gEUD2 differences were observed (range: 105-161 Gy); mean-PTV dose, PTV-HI, PTV-CI, and PTV-GI were, respectively, 56.8 ± 3.4 Gy, 14.2 ± 10.1%, 0.70 ± 0.15, and 4.9 ± 1.9. Significant correlations for PTV-gEUD2 versus PTV-HI, and MLD2 versus PTV-GI, were observed. Conclusions: The differences in terms of PTV-gEUD2 may suggest the inclusion of PTV-gEUD2 calculation for retrospective data inter-comparison.

KW - Dosimetry

KW - Lung

KW - Multicentric clinical trial

KW - Radiobiology

KW - Stereotactic ablative radiotherapy (SABR)

KW - Stereotactic body radiation therapy (SBRT)

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