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Program Information

SRS/SBRT: Clinical Implementation and Small Volume Dose Limits in Brain/spine

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C Tseng

L Ma

A Sethi

C Tseng1*, L Ma2*, A Sethi3*, (1) Sunnybrook Health Sciences Centre, Toronto, ON, (2) UCSF Comprehensive Cancer Center, San Francisco, CA, (3) Loyola University Medical Center, Maywood, IL


10:00 AM : Spine SBRT: A clinician's update on techniques and outcomes - C Tseng, Presenting Author
10:40 AM : Small volume dose limits in planning brain/spine SRS/SBRT - L Ma, Presenting Author
11:20 AM : Clinical Implementations of SRS/SBRT programs - A Sethi, Presenting Author

TH-CD-201-0 (Thursday, August 3, 2017) 10:00 AM - 12:00 PM Room: 201

Safe and effective implementation of SRS/SBRT programs requires a comprehensive multidisciplinary team approach and thorough understanding of clinical goals and workflows. Additionally, one must pay attention to treatment planning caveats, such as, small-volume dose limits, and basic physics and applications of a wide-array of clinical tools: detectors, phantoms, treatment planning systems, and treatment protocols.

The presentation will consist of three components: (1) a clinician’s perspective on updated techniques and clinical outcomes using spine SBRT as an example, (2) a clinical planner’s perspective on implementing small volume dose limits in optimizing complex SRS/SBRT treatments, and (3) a physicist’s perspective on comparative evaluation of small-field detectors commonly used in SRS/SBRT commissioning and a systematic review of SRS/SBRT QA programs.

Throughout the session, interesting clinical cases will be shown to emphasize careful and efficient planning techniques with SRS and SBRT. Appropriate clinical indications for spine SBRT, evidence-based dose limits to critical organs-at-risk, clinical outcomes and patterns of failure post-SBRT will be summarized, which underscore the importance of achieving high quality plans. The impact of plan parameters on generating desired treatment plans will be discussed. Methods to evaluate treatment plans and their conformance to RTOG protocols will be presented.

Learning Objectives:
1. Understand the indications and updated clinical outcome data relevant to spine SBRT, and appreciate clinical SRS/SBRT practice from a clinician’s point of view.
2. Familiarize with small-volume dose limits and specifications per AAPM task group reports, clinical protocols, and recent literature.
3. Gain knowledge of SRS/SBRT detectors and phantoms from various vendors, including important steps in beam data acquisition, validation and treatment plan commissioning, plus common associated pitfalls and methods of troubleshooting.
4. Review practical clinical examples highlighting effective, consistent and efficient planning/evaluation techniques.


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