Alcorn Sara, Nilsson Kristina, Rao Avani D, Ladra Matthew M, Ermoian Ralph P, Villar Rosangela C, Chen Michael J, Kobyzeva Daria, Nechesnyuk Alexey V, Ford Eric, MacDonald Shannon, Winey Brian, Dieckmann Karin, Terezakis Stephanie A
Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins School of Medicine, Baltimore, MD.
Department of Oncology, Uppsala University Hospital, Uppsala, Sweden.
J Pediatr Hematol Oncol. 2018 Oct;40(7):522-526. doi: 10.1097/MPH.0000000000001290.
PURPOSE/OBJECTIVES: There is little consensus regarding the application of stereotactic radiotherapy (SRT) in pediatrics. We evaluated patterns of pediatric SRT practice through an international research consortium.
Eight international institutions with pediatric expertise completed a 124-item survey evaluating patterns of SRT use for patients 21 years old and younger. Frequencies of SRT use and median margins applied with and without SRT were evaluated.
Across institutions, 75% reported utilizing SRT in pediatrics. SRT was used in 22% of brain, 18% of spine, 16% of other bone, 16% of head and neck, and <1% of abdomen/pelvis, lung, and liver cases across sites. Of the hypofractionated SRT cases, 42% were delivered with definitive intent. Median gross tumor volume to planning target volume margins for SRT versus non-SRT plans were 0.2 versus 1.4 cm for brain, 0.3 versus 1.5 cm for spine/other bone, 0.3 versus 2.0 cm for abdomen/pelvis, 0.7 versus 1.5 cm for head and neck, 0.5 versus 1.7 cm for lung, and 0.5 versus 2.0 cm for liver sites.
SRT is commonly utilized in pediatrics across a range of treatment sites. Margins used for SRT were substantially smaller than for non-SRT planning, highlighting the utility of this approach in reducing treatment volumes.
目的/目标：关于立体定向放射治疗（SRT）在儿科中的应用，目前几乎没有共识。我们通过一个国际研究联盟评估了儿科SRT的应用模式。
八个具有儿科专业知识的国际机构完成了一项包含124个项目的调查，评估了21岁及以下患者的SRT使用模式。评估了SRT的使用频率以及使用和不使用SRT时应用的中位边界。
在各个机构中，75%报告在儿科中使用SRT。在所有部位中，SRT用于22%的脑部、18%的脊柱、16%的其他骨骼、16%的头颈部，以及腹部/盆腔、肺部和肝脏病例的比例均小于1%。在超分割SRT病例中，42%是确定性治疗目的。SRT与非SRT计划的大体肿瘤体积到计划靶体积的中位边界，脑部分别为0.2厘米对1.4厘米，脊柱/其他骨骼为0.3厘米对1.5厘米，腹部/盆腔为0.3厘米对2.0厘米，头颈部为0.7厘米对1.5厘米，肺部为0.5厘米对1.7厘米，肝脏部位为0.5厘米对2.0厘米。
SRT在儿科的一系列治疗部位中普遍使用。SRT使用的边界明显小于非SRT计划，突出了这种方法在减少治疗体积方面的效用。
