Australasian Gastrointestinal Trials Group (AGITG) and Trans-Tasman Radiation Oncology Group (TROG) Guidelines for Pancreatic Stereotactic Body Radiation Therapy (SBRT)

Authors

Andrew Oar
Mark Lee
Hien Le
George Hruby
Raymond Dalfsen
David Pryor
Dominique Lee
Julie Chu
Lois C. Holloway, University of WollongongFollow
Adam Briggs
Andrew Barbour
Sarat Chander
Sweet Ng
Jas Samara Phil
John Shakeshaft
David Goldstein
Nam Nguyen
Karyn Goodman
Daniel T. Chang
Andrew Kneebone

RIS ID

139031

Publication Details

Oar, A., Lee, M., Le, H., Hruby, G., Dalfsen, R., Pryor, D., Lee, D., Chu, J., Holloway, L., Briggs, A., Barbour, A., Chander, S., Ng, S., Phil, J. Samara., Shakeshaft, J., Goldstein, D., Nguyen, N., Goodman, K., Chang, D. T. & Kneebone, A. (2019). Australasian Gastrointestinal Trials Group (AGITG) and Trans-Tasman Radiation Oncology Group (TROG) Guidelines for Pancreatic Stereotactic Body Radiation Therapy (SBRT). Practical Radiation Oncology,

Abstract

2019 American Society for Radiation Oncology Purpose: Nonrandomized data exploring pancreas stereotactic body radiation therapy (SBRT) has demonstrated excellent local control rates and low toxicity. Before commencing a randomized trial investigating pancreas SBRT, standardization of prescription dose, dose constraints, simulation technique, and clinical target volume delineation are required. Methods and Materials: Specialists in radiation oncology, medical oncology, hepatobiliary surgery, and gastroenterology attended 2 consecutive Australasian Gastrointestinal Trials Group workshops in 2017 and 2018. Sample cases were discussed during workshop contact with specifically invited international speakers highly experienced in pancreas SBRT. Furthermore, sample cases were contoured and planned between workshop contact to finalize dose constraints and clinical target volume delineation. Results: Over 2 separate workshops, consensus was reached on dose and simulation technique. The working group recommended a dose prescription of 40 Gy in 5 fractions. Treatment delivery during end-expiratory breath hold with triple-phase contrast enhanced computed tomography was recommended. In addition, dose constraints, stepwise contouring guidelines, and an anatomic atlas for pancreatic SBRT were developed. Conclusions: Pancreas SBRT is emerging as a promising treatment modality requiring prospective evaluation in randomized studies. This work attempts to standardize dose, simulation technique, and volume delineation to support the delivery of high quality SBRT in a multicenter study.