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Timely stereotactic body radiotherapy (SBRT) for spine metastases using a rapidly deployable automated planning
Omar Y Mian1, Owen Thomas2, Joy J Y Lee3
1Department of Radiation Oncology, Cleveland Clinic, Taussig Cancer Institute, Cleveland, OH USA.
Springerplus
|August 27, 2016
Summary
An automated planning script for spine SBRT significantly reduces treatment time while maintaining dosimetric quality. This approach is ideal for urgent cases and resource-limited settings, improving patient care through rapid yet robust treatment delivery.
Area of Science:
- Radiation Oncology
- Medical Physics
- Cancer Treatment
Background:
- Spine stereotactic body radiation therapy (SBRT) requires complex planning and quality assurance, hindering its use in time-sensitive or resource-limited clinical scenarios.
- Automated planning solutions are needed to streamline SBRT delivery for spinal lesions.
Purpose of the Study:
- To develop and validate an automated inverse planning algorithm, Rapid Spine (RaSp), for streamlining single-fraction spine SBRT.
- To assess the feasibility of rapid, conformal SBRT delivery using widely available technology.
Main Methods:
- The Rapid Spine (RaSp) automated script generated single-fraction SBRT plans for 14 complex spinal lesions.
- Plans were limited to 5 beams and 15 segments, optimized to RTOG 0631 objectives.
- Automated plans were compared against standard single-fraction stereotactic IMRT plans, with a 2 mm posterior isocenter shift simulated for error analysis.
Main Results:
- Automated RaSp plans were generated in under 5 minutes, with mean PTV dose of 1663 cGy.
- IMRT plans required longer generation times but offered more favorable dose escalation.
- A 2 mm posterior shift increased cord dose by 10% for RaSp plans versus 20% for IMRT plans, with fewer cord dose violations for RaSp.
Conclusions:
- The RaSp automated method provides timely and dosimetrically acceptable SBRT plans for spine lesions.
- RaSp plans meet RTOG 0631 objectives, enabling rapid quality assurance and expedited treatment.
- This automated approach effectively balances rapid treatment delivery with optimal dosimetry, particularly in urgent or resource-limited situations.
