Titre
Refining Treatment Planning in STereotactic Arrhythmia Radioablation: Benchmark Results and Consensus Statement From the STOPSTORM.eu Consortium.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Auteur(s)
Trojani, V.
Auteure/Auteur
Grehn, M.
Auteure/Auteur
Botti, A.
Auteure/Auteur
Balgobind, B.
Auteure/Auteur
Savini, A.
Auteure/Auteur
Boda-Heggemann, J.
Auteure/Auteur
Miszczyk, M.
Auteure/Auteur
Elicin, O.
Auteure/Auteur
Krug, D.
Auteure/Auteur
Andratschke, N.
Auteure/Auteur
Schmidhalter, D.
Auteure/Auteur
van Elmpt, W.
Auteure/Auteur
Bogowicz, M.
Auteure/Auteur
de Areba Iglesias, J.
Auteure/Auteur
Dolla, L.
Auteure/Auteur
Ehrbar, S.
Auteure/Auteur
Fernandez-Velilla, E.
Auteure/Auteur
Fleckenstein, J.
Auteure/Auteur
Granero, D.
Auteure/Auteur
Henzen, D.
Auteure/Auteur
Hurkmans, C.
Auteure/Auteur
Kluge, A.
Auteure/Auteur
Knybel, L.
Auteure/Auteur
Loopeker, S.
Auteure/Auteur
Mirandola, A.
Auteure/Auteur
Richetto, V.
Auteure/Auteur
Sicignano, G.
Auteure/Auteur
Vallet, V.
Auteure/Auteur
van Asselen, B.
Auteure/Auteur
Worm, E.
Auteure/Auteur
Pruvot, E.
Auteure/Auteur
Verhoeff, J.
Auteure/Auteur
Fast, M.
Auteure/Auteur
Iori, M.
Auteure/Auteur
Blanck, O.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1879-355X
Statut éditorial
Publié
Date de publication
2025-01-01
Volume
121
Numéro
1
Première page
218
Dernière page/numéro d’article
229
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Publication Status: ppublish
Résumé
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.
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.
Twenty centers submitted 67 treatment plans for this study. In most plans (75%) intensity modulated arc therapy with 6 MV flattening filter free beams was used. Dose prescription was mainly based on PTV D <sub>95%</sub> (49%) or D <sub>96%-100%</sub> (19%). Many participants preferred to spare close extracardiac organs-at-risk (75%) and cardiac substructures (50%) by PTV coverage reduction. PTV D <sub>0.035cm3</sub> 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.
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.
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.
Twenty centers submitted 67 treatment plans for this study. In most plans (75%) intensity modulated arc therapy with 6 MV flattening filter free beams was used. Dose prescription was mainly based on PTV D <sub>95%</sub> (49%) or D <sub>96%-100%</sub> (19%). Many participants preferred to spare close extracardiac organs-at-risk (75%) and cardiac substructures (50%) by PTV coverage reduction. PTV D <sub>0.035cm3</sub> 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.
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.
Sujets
PID Serval
serval:BIB_C458793F2506
PMID
Open Access
Oui
Date de création
2024-08-19T08:31:21.989Z
Date de création dans IRIS
2025-05-20T23:25:47Z
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Nom
39122095.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
1.31 MB
Format
Adobe PDF
PID Serval
serval:BIB_C458793F2506.P001
URN
urn:nbn:ch:serval-BIB_C458793F25068
Somme de contrôle
(MD5):fa8291587a86e34065eb06f79772afcc