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英国立体定向消融体部放射治疗的现状:六年进展

Current status of stereotactic ablative body radiotherapy in the UK: six years of progress.

作者信息

Distefano Gail, Garikipati Satya, Grimes Helen, Hatton Matthew

机构信息

Weston Park Hospital, Sheffield, UK.

University College London Hospitals, London, UK.

出版信息

BJR Open. 2019 Jul 19;1(1):20190022. doi: 10.1259/bjro.20190022. eCollection 2019.

Abstract

OBJECTIVE

To update the 2012 UK stereotacticablative radiotherapy (SABR) Consortium survey and assess the development of SABR services across the UK over the past 6 years. Use the results to share practice and continue to drive forward technique development, aid standardization and by highlighting issues, improve access to SABR services and trials across the UK.

METHODS

In January 2018, an online questionnaire was sent by the UK SABR Consortium to 65 UK radiotherapy institutions covering current service provision and collecting data on immobilization, motion management, scanning protocols, target/OAR delineation, planning, image-guidance, quality assurance and future plans.

RESULTS

50 (77%) institutions responded, 38 ( 15 in 2012) indicated they had an active SABR programme with the remaining 12 centres intending to develop a SABR programmeDocumented changes include the development of Linac delivered SABR to non-lung sites, an increase in centres using abdominal compression (14 2) and the introduction of four-dimensional cone beam CBCT. Current practice is broadly in line with UK SABR Consortium and European guidelines.

CONCLUSION

This 2018 survey shows a welcome increase in SABR provision, surpassing 2012 projections. However, it is clear that the UK SABR program needs to continue to expand to ensure that patients with oligometastatic disease have access and SABR for early stage lung cancer is available in all centres. Updated guidance that addresses variability in target delineation, image guidance and reduces patient specific quality assurance is warranted.

ADVANCES IN KNOWLEDGE

Documented progress of UK SABR across all treatment sites over the last six years, barriers to implementation and future plans.

摘要

目的

更新2012年英国立体定向消融放疗(SABR)联盟调查,评估过去6年英国SABR服务的发展情况。利用结果分享实践经验,继续推动技术发展,助力标准化,并通过突出问题,改善全英国SABR服务及试验的可及性。

方法

2018年1月,英国SABR联盟向65家英国放疗机构发送了一份在线调查问卷,内容涵盖当前服务提供情况,并收集有关固定、运动管理、扫描方案、靶区/危及器官勾画、计划制定、图像引导、质量保证及未来计划的数据。

结果

50家(77%)机构回复,38家(2012年为15家)表示他们有活跃的SABR项目,其余12个中心打算开展SABR项目。记录的变化包括直线加速器实施的SABR扩展至非肺部部位、使用腹部压迫的中心增加(从2家增至14家)以及引入四维锥形束CBCT。当前实践大致符合英国SABR联盟及欧洲指南。

结论

2018年的这项调查显示SABR服务的提供量有了令人欣喜的增长,超过了2012年的预期。然而,很明显英国的SABR项目需要继续扩大,以确保寡转移疾病患者能够获得该服务,并且所有中心都能提供早期肺癌的SABR治疗。有必要更新指南,以解决靶区勾画、图像引导方面的差异,并减少针对患者的质量保证。

知识进展

记录了过去六年英国SABR在所有治疗部位的进展、实施障碍及未来计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f4c/7592489/7abdff7a63ac/bjro.20190022.g001.jpg

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