Perks J, Benedict S
UC Davis Medical Center, Sacramento, CA.
University of Virginia Health Systems, Charlottesville, VA.
Med Phys. 2012 Jun;39(6Part21):3873. doi: 10.1118/1.4735813.
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- 41013. 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;76:326-3324. 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) Learning Objectives: 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.
立体定向体部放射治疗（SBRT）的技术优势基于能够将非均匀剂量的大分割疗程精准投送至明确界定的靶区，且在靶区外剂量迅速衰减。总体目标是给予靶区消融剂量，同时将辐射对周围正常组织的影响降至最低。SBRT的主要优势在于与适形性较差的常规分割技术相比，其给予靶区的生物学有效剂量更高。在本报告中，将回顾美国放射学会（ACR）、美国放射肿瘤学会（ASTRO）和美国医学物理学家协会（AAPM）制定的SBRT质量保证和安全的既定建议。这些建议包括建立SBRT诊所、设备和影像考量、人员配备及资质概述、治疗计划考量、培训、验收和调试操作以及安全检查表的使用。此外，还介绍了立体定向体部放射治疗实施的失效模式与效应分析（FMEA）。参考文献：1. Timothy D. Solberg博士、James M. Balter博士、Stanley H. Benedict博士、Benedick A. Fraass博士、Brian Kavanagh医学博士、Curtis Miyamoto医学博士、Todd Pawlicki博士、Louis Potters医学博士、Yoshiya Yamada医学博士，“立体定向放射外科和立体定向体部放射治疗中的质量和安全考量”《实用放射肿瘤学》（2011年）2. Benedict SH、Yenice KM、Followill D等，“立体定向体部放射治疗：AAPM任务组101报告”《医学物理》。2010年；37:4078 - 41013. Potters L、Kavanagh B、Galvin JM等。美国放射治疗及肿瘤学会（ASTRO）和美国放射学会（ACR）立体定向体部放射治疗实施的实践指南。《国际放射肿瘤学·生物学·物理学》。2010年；76:326 - 3324. Julian R. Perks博士、Sinisa Stanic医学博士、Robin L Stern博士、Barbara Henk注册护士（RN），护理学硕士（MSN）、Marsha S Nelson注册护士（RN），工商管理硕士（MBA）、Rick D Harse放射治疗技师（RTT）、Mathew Mathai理学学士（BS），医学博士（CMD）、James A Purdy博士、Richard K Valicenti医学博士，文学硕士（MA）、Allan D Siefkin医学博士和Allen M Chen医学博士，“立体定向体部放射治疗实施的失效模式与效应分析”《国际放射肿瘤学·生物学·物理学》。2012年（即将出版）学习目标：1. 回顾并理解ASTRO关于SBRT质量保证和安全的建议2. 回顾并理解AAPM任务组关于SBRT的建议3. 回顾并理解SBRT的FMEA分析
