Launching a Stereotactic Body Radiation Therapy Program

Part of the Medical Radiology book series (MEDRAD)


Stereotactic body radiation therapy (SBRT) delivers very high, very conformal inhomogeneous doses of radiation to well-defined targets with small or no margins to potentially heterogeneous and potentially physiologically moving targets in the thorax, abdomen, or paraspinal regions in few fractions. Embarking on SBRT requires a significant investment of personnel and equipment and should be undertaken after a thorough review of goals and allocation of personnel and equipment resources. In order to deliver SBRT accurately, all phases of the treatment process are integrated into the SBRT delivery system and controlled to the greatest degree possible. There are a number of American Association of Physicist in Medicine (AAPM) Task Group reports, American College of Radiology (ACR) practice guidelines, and American Society for Radiation Oncology (ASTRO) white papers to draw upon for guidance in implementing each phase of SBRT. The phases include imaging for target definition, immobilization, simulation, planning, motion management, imaging for alignment, and beam delivery. In each phase, the appropriate equipment is applied by trained personnel using processes developed during implementation to deliver the treatment as established by the quality assurance program.


Intensity Modulate Radiation Therapy Stereotactic Body Radiation Therapy Radiation Therapy Oncology Group Task Group Motion Management 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Benedict SH, Yenice KM, Followill D, Galvin JM, Hinson W, Kavanagh B et al. (2010) Stereotactic body radiation therapy: the report of AAPM task group 101. Med Phys 37(8):4078 1 Jan 2010Google Scholar
  2. Bezjak A, Bradley J, Gaspar L, Timmerman RD, Papiez L, Gore E et al. (2012) RTOG 0813 seamless phase I/II study of stereotactic lung radiotherapy (SBRT) for early stage, centrally located, non small cell lung cancer (NSCLC) in medically inoperable patients, pp 1–81Google Scholar
  3. Bissonnette J-P, Balter PA, Dong L, Langen KM, Lovelock DM, Miften M et al (2012) Quality assurance for image-guided radiation therapy utilizing CT-based technologies: a report of the AAPM TG-179. Med Phys 39(4):1946PubMedCrossRefGoogle Scholar
  4. Feuvret L, Noel G, Mazeron J, Bey P (2006) Conformity index: a review. Int J Radiat Oncol Biol Phys 64(2):333–342Google Scholar
  5. Fraass B, Doppke K, Hunt M, Kutcher G, Starkschall G, Stern R, et al. (1998) American association of physicists in medicine radiation therapy committee task group 53: quality assurance for clinical radiotherapy treatment planning. Med Phys pp 1773–1829Google Scholar
  6. Kissick MW, Mackie TR (2009) Task group 76 report on “the management of respiratory motion in radiation oncology” [Med Phys 33:3874–3900 (2006)]. Med Phys 36(12):5721–5722PubMedCrossRefGoogle Scholar
  7. Klein EE, Hanley J, Bayouth J, Yin F–F, Simon W, Dresser S et al. (2009) Task Group 142 report: quality assurance of medical accelerators. Med Phys pp 4197–4212Google Scholar
  8. Mutic S, Palta JR, Butker EK, Das IJ, Huq MS, Loo L-ND et al (2003) Quality assurance for computed-tomography simulators and the computed-tomography-simulation process: report of the AAPM radiation therapy committee Task Group No. 66. Med Phys 30(10):2762PubMedCrossRefGoogle Scholar
  9. Potters L, Kavanagh B, Galvin JM, Hevezi JM, Janjan NA, Larson DA et al (2010) 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 76(2):326–332PubMedCrossRefGoogle Scholar
  10. Prescribing, Recording and Reporting Photon Beam Therapy (Supplement to ICRU Report 50), ICRU Report 62, 2001. International Commission on Radiation Units and Measurement, BethesdaGoogle Scholar
  11. Ryu S, Gerszten P, Yin F–F, Timmerman RD, Dicker A, Movsas B et al (2012) RTOG 0631 phase II/III study of image-guided radiosurgery/SBRT for localized spine metastasis. Radiat Therapy Oncol Group 3:1–65Google Scholar
  12. Solberg TD, Balter JM, Benedict SH, Fraass BA, Kavanagh B, Miyamoto C et al. (2012a) Quality and safety considerations in stereotactic radiosurgery and stereotactic body radiation therapy: Executive summary. Supplementary material. PRO 2(1):Supplemental pp 1–49Google Scholar
  13. Solberg TD, Balter JM, Benedict SH, Fraass BA, Kavanagh B, Miyamoto C et al. (2012b) Quality and safety considerations in stereotactic radiosurgery and stereotactic body radiation therapy: Executive summary. PRO 2(1):2–9Google Scholar
  14. Timmerman RD, Galvin J, Gore E, Bae K, Pass H, Edelman MJ, et al. RTOG 0618 A Phase II Trial of Stereotactic Body Radiation Therapy (SBRT) in the Treatment of Patients with Operable Stage I/II Non-Small Cell Lung Cancer. 17 May 2007:1–66Google Scholar
  15. Videtic GMM, Singh AK, Chang JY, Le Q-T, Parker W, Olivier KR, Schild SE, Bae K (2010) RTOG 0915 (NCCTG N0927) A randomized phase II study comparing 2 stereotactic body radiation therapy (SBRT) schedules for medically inoperable patients with stage 1 peripheral non-small cell lung cancer, pp 1–66Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Radiation OncologyUniversity of CincinnatiCincinnatiUSA

Personalised recommendations