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SBRT (Part 2): Physics and Quality Assurance Updates


J Perks


J Perks1*, S Benedict2, (1) UC Davis Medical Center, Sacramento, CA, (2) University of Virginia Health Systems, Charlottesville, VA

MO-F-BRCD-2 Monday 4:30:00 PM - 6:00:00 PM Room: Ballroom CD

The technical advantage of stereotactic body radiation therapy (SBRT) is based upon the ability to deliver a hypofractionated course of heterogeneous dose to a well-defined volume with a rapid fall-off of dose outside the treatment volume. The overall goal is to deliver an ablative dose to the target while minimizing the effects of radiation on the surrounding normal tissue. The major advantage of SBRT is the greater biologically effective dose to the target than that permitted by less conformal, fractionated techniques. In this presentation the established recommendations for quality assurance and safety of SBRT from ACR, ASTRO, and AAPM will be reviewed. The recommendations include establishing an SBRT clinic, equipment and imaging considerations, overview of staffing and personnel qualifications, treatment planning considerations, training, acceptance and commissioning practices, and use of safety checklists. Additionally, a Failure Mode and Effect Analysis (FMEA) for Stereotactic Body Radiation Therapy Delivery is presented.

References:
1. Timothy D. Solberg PhD, James M. Balter PhD, Stanley H. Benedict PhD ,Benedick A. Fraass PhD, Brian Kavanagh MD, Curtis Miyamoto MD , Todd Pawlicki PhD, Louis Potters MD, Yoshiya Yamada MD , “Quality and safety considerations in stereotactic radiosurgery and stereotactic body radiation therapy” Practical Radiation Oncology (2011)
2. Benedict SH, Yenice KM, Followill D, et al., “Stereotactic Body Radiation Therapy: The Report of AAPM Task Group 101” Med Phys. 2010;37:4078–4101
3. Potters L, Kavanagh B, Galvin JM, et al. American Society for Therapeutic Radiology and Oncology (ASTRO) and American College of Radiology (ACR) practice guideline for the performance of stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys. 2010;76:326–332
4. Julian R. Perks PhD, Sinisa Stanic MD, Robin L Stern PhD, Barbara Henk RN MSN, Marsha S Nelson RN MBA, Rick D Harse RTT, Mathew Mathai BS CMD, James A Purdy PhD, Richard K Valicenti MD MA, Allan D Siefkin MD and Allen M Chen MD, “Failure Mode and Effect Analysis for Stereotactic Body Radiation Therapy Delivery” Int J Radiat Oncol Biol Phys. 2012 (in press)

Educational Objectives/Points to cover:
1. Review and understand the ASTRO Recommendations for QA and Safety with SBRT
2. Review and understand the AAPM Task Group Recommendations for SBRT
3. Review and understand a FEMA Analysis of SBRT


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