Refining Treatment Planning in STereotactic Arrhythmia Radioablation: Benchmark Results and Consensus Statement From the STOPSTORM.eu Consortium
Por:
Trojani, Valeria, Grehn, Melanie, Botti, Andrea, Balgobind, Brian, Savini, Alessandro, Boda-Heggemann, Judit, Miszczyk, Marcin, Elicin, Olgun, Krug, David, Andratschke, Nicolaus, Schmidhalter, Daniel, van Elmpt, Wouter, Bogowicz, Marta, Iglesias, Javier de Areba, Dolla, Lukasz, Ehrbar, Stefanie, Fernandez-Velilla, Enric, Fleckenstein, Jens, Granero, Domingo, Henzen, Dominik, Hurkmans, Coen, Kluge, Anne, Knybel, Lukas, Loopeker, Sandy, Mirandola, Alfredo, Richetto, Veronica, Sicignano, Gianluisa, Vallet, Veronique, van Asselen, Bram, Worm, Esben, Pruvot, Etienne, Verhoeff, Joost, Fast, Martin, Iori, Mauro, Blanck, Oliver
Publicada:
1 ene 2025
Ahead of Print:
1 dic 2024
Resumen:
Purpose: STereotactic Arrhythmia Radioablation (STAR) showed promising
results in patients with refractory ventricular tachycardia. However,
clinical data are scarce and heterogeneous. The STOPSTORM.eu consortium
was established to investigate and harmonize STAR in Europe. The primary
goal of this benchmark study was to investigate current treatment
planning practice within the STOPSTORM project as a baseline for future
harmonization. Methods and Materials: Planning target volumes (PTVs)
overlapping extracardiac organs-at-risk and/or cardiac substructures
were generated for 3 STAR cases. Participating centers were asked to
create single-fraction treatment plans with 25 Gy dose prescriptions
based on in-house clinical practice. All treatment plans were reviewed
by an expert panel and quantitative crowd knowledge-based analysis was
performed with independent software using descriptive statistics for
International Commission on Radiation Units and Measurements report 91
relevant parameters and crowd dose-volume histograms. Thereafter,
treatment planning consensus statements were established using a
dual-stage voting process. Results: Twenty centers submitted 67
treatment plans for this study. In most plans (75%) intensity modulated
arc therapy with 6 MV fl attening fi lter free beams was used. Dose
prescription was mainly based on PTV D 95% (49%) or D 96%-100% (19%).
Many participants preferred to spare close extracardiac organs-at-risk
(75%) and cardiac substructures (50%) by PTV coverage reduction. PTV D
0.035cm3 ranged from 25.5 to 34.6 Gy, demonstrating a large variety of
dose inhomogeneity. Estimated treatment times without motion
compensation or setup ranged from 2 to 80 minutes. For the consensus
statements, a strong agreement was reached for beam technique planning,
dose calculation, prescription methods, and trade-offs between target
and extracardiac critical structures. No agreement was reached on
cardiac substructure dose limitations and on desired dose inhomogeneity
in the target. Conclusions: This STOPSTORM multicenter treatment
planning benchmark study not only showed strong agreement on several
aspects of STAR treatment planning, but also revealed disagreement on
others. To standardize and harmonize STAR in the future, consensus
statements were established; however, clinical data are urgently needed
for actionable guidelines for treatment planning. (c) 2024 The Authors.
Published by Elsevier Inc. This is an open access article under the CC
BY license (http:// creativecommons.org/licenses/by/4.0/)
Filiaciones:
AUSL IRCCS Reggio Emilia, Dept Med Phys, Reggio Emilia, Italy
Univ Med Ctr Schleswig Holstein, Dept Radiat Oncol, Kiel, Germany
Amsterdam UMC, Dept Radiat Oncol, Dept Radiat Oncol, Amsterdam,
Netherlands
G Mazzini Hosp, Dept Neurosurg, Teramo, Italy
Heidelberg Univ, Med Fac Mannheim, Univ Med Ctr Mannheim, Dept Radiat
Oncol, Mannheim, Germany
Maria Sklodowska Curie Natl Res Inst Oncol, Radiotherapy & Chemotherapy
Dept 3, PL-44102 Gliwice, Poland
WSB Univ, Fac Appl Sci, Dabrowa Gornicza, Poland
Univ Bern, Bern Univ Hosp, Div Med Radiat Phys, Inselspital, Bern,
Switzerland
Univ Hosp Zurich, Dept Radiat Oncol, Zurich, Switzerland
Maastricht Univ, Med Ctr, GROW Sch Oncol & Reprod, Dept Radiat Oncol
Maastro, Maastricht, Netherlands
Hosp Clin San Carlos, Med Phys Dept, Madrid, Spain
Maria Sklodowska Curie Natl Res Inst Oncol, Radiotherapy Planning Dept,
Gliwice, Poland
Pompeu & Fabra Univ, Hosp del Mar, Dept Ophthalmol, Barcelona, Spain
Hosp Gen Valencia, Dept Radiat Oncol, Valencia, Spain
Catharina Hosp, Dept Radiat Oncol, Eindhoven, Netherlands
Tech Univ Eindhoven, Dept Appl Phys & Elect Engn, Eindhoven, Netherlands
Tech Univ Eindhoven, Dept Appl Phys, Eindhoven, Netherlands
Charite Univ Med Berlin, Dept Radiooncol, Berlin, Germany
Univ Hosp Ostrava, Dept Oncol, Ostrava, Czech Republic
Fac Med, Ostrava, Czech Republic
Natl Ctr Oncol Hadrontherapy, Fdn CNAO, Pavia, Italy
AOU Citta Salute & Sci Torino, Med Phys Unit, Turin, Italy
IRCCS Sacro Cuore Don Calabria Hosp, Adv Radiat Oncol Dept, Negrar
Verona, Italy
Lausanne Univ Hosp, Radiooncol Dept, Lausanne, Switzerland
Univ Med Ctr Utrecht, Dept Radiotherapy, Utrecht, Netherlands
Aarhus Univ Hosp, Dept Oncol, Aarhus, Denmark
Lausanne Univ Hosp, Serv Cardiol, Heart & Vessel Dept, Lausanne,
Univ Lausanne, Lausanne, Switzerland
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