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Stereotactic body radiotherapy for liver tumors

Principles and practical guidelines of the DEGRO Working Group on Stereotactic Radiotherapy

Stereotaktische Strahlentherapie von Lebertumorenn

Grundlegende und praktische Leitlinien der DEGRO Arbeitsgruppe Stereotaxie

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Abstract

Purpose

This report of the Working Group on Stereotactic Radiotherapy of the German Society of Radiation Oncology (DEGRO) aims to provide a practical guideline for safe and effective stereotactic body radiotherapy (SBRT) of liver tumors.

Methods

The literature on the clinical evidence of SBRT for both primary liver tumors and liver metastases was reviewed and analyzed focusing on both physical requirements and special biological characteristics.

Results

Recommendations were developed for patient selection, imaging, planning, treatment delivery, motion management, dose reporting, and follow-up. Radiation dose constraints to critical organs at risk are provided.

Conclusion

SBRT is a well-established treatment option for primary and secondary liver tumors associated with low morbidity.

Zusammenfassung

Ziel

Die Arbeitsgruppe Stereotaxie der Deutschen Gesellschaft für Radioonkologie (DEGRO) legt hier eine Empfehlung zur sicheren und effektiven Durchführung der SBRT von Lebertumoren vor.

Methoden

Eine Literaturrecherche zur Untersuchung der Evidenz der SBRT sowohl für primäre Lebertumore als auch für Lebermetastasen wurde durchgeführt. Auf dieser Basis werden Empfehlungen für technisch-physikalische Voraussetzungen wie auch für die tägliche Praxis der Leber-SBRT gegeben. Weiterhin werden radiobiologische Besonderheiten dieses Verfahrens dargestellt.

Ergebnisse

Praktische Vorgaben werden für Patientenselektion, Bildgebung, Planung, Applikation, Bewegungsmanagement, Dosisdokumentation und Follow-up gegeben. Dosisempfehlungen für die kritischen Risikoorgane werden dargestellt.

Schlussfolgerung

Die SBRT stellt eine etablierte Behandlungsmethode für primäre und sekundäre Lebertumore dar und ist mit niedriger Morbidität assoziiert.

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Conflict of interest

F. Sterzing, T. B. Brunner, I. Ernst, W. W. Baus, B. Greve, K. Herfarth, and M. Guckenberger state that there are no conflicts of interest.

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Authors and Affiliations

  1. Klinische Kooperationseinheit Strahlentherapie, Deutsches Krebsforschungszentrum (dkfz), INF 280, 69120, Heidelberg, Germany

    Florian Sterzing

  2. Abteilung für Radioonkologie und Strahlentherapie, Radiologische Universitätsklinik, Heidelberg, Germany

    Florian Sterzing & Klaus Herfarth

  3. Klinik für Strahlenheilkunde, Radiologische Klinik, Universitätsklinikum Freiburg, Freiburg, Germany

    Thomas B. Brunner

  4. Klinik für Strahlentherapie – Radioonkologie, Universitätsklinikum Münster, Münster, Germany

    Iris Ernst & Burkhard Greve

  5. Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Köln, Köln, Germany

    Wolfgang W. Baus

  6. Klinik für Radio-Onkologie, UniversitätsSpital Zürich, Zürich, Switzerland

    Matthias Guckenberger

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  1. Florian Sterzing
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  2. Thomas B. Brunner
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  3. Iris Ernst
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  4. Wolfgang W. Baus
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  5. Burkhard Greve
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  6. Klaus Herfarth
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  7. Matthias Guckenberger
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Correspondence to Florian Sterzing.

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Sterzing, F., Brunner, T., Ernst, I. et al. Stereotactic body radiotherapy for liver tumors. Strahlenther Onkol 190, 872–881 (2014). https://doi.org/10.1007/s00066-014-0714-1

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