Definition and requirements for stereotactic radiotherapy: a systematic review

Area of Science:

• Radiation Oncology
• Medical Physics
• Radiotherapy Technology

Background:

• Stereotactic radiotherapy (SRT) is widely used in clinical practice.
• Existing definitions and quality standards for SRT show considerable international inconsistencies.
• There is a need to consolidate current practices and address variability in SRT implementation.

Purpose of the Study:

• To systematically review and consolidate current definitions of stereotactic radiotherapy.
• To identify commonly proposed quality standards for SRT.
• To address inconsistencies in international SRT practices.

Main Methods:

• Systematic literature review following PRISMA methodology.
• Searches conducted across major databases (PubMed, Embase, Cochrane, Scopus, Epistemonikos) from January 2001 to April 2024.
• Data extraction focused on definitions, staffing, technology, and quality assurance procedures for SRT.

Main Results:

• Analysis of 51 articles revealed significant discrepancies in SRT definitions and standards.
• Commonly proposed standards include targeting accuracy (≤1 mm for SRS, ≤2 mm for SBRT) and high doses per fraction (≥5 Gy).
• Multidisciplinary staffing, advanced imaging, precise immobilization, and rigorous quality assurance were consistently emphasized.

Conclusions:

• Substantial variability exists in SRT definitions and implementation despite its widespread adoption.
• There is a critical need for unified, updated guidelines for SRT.
• Standardized clinical practices and incorporation of technological advancements are essential for consistent, high-quality patient outcomes.