MO-C-BRD-01: SBRT I: Overview of Simulation, Planning, and Delivery.

SBRT is having a dramatic impact on radiation therapy of early-stage, locally advanced cancers. Treatment planning of SBRT is characterized by precise target volume delineation, highly conformal dose distribution, sharp dose gradient outside the target volume, and meticulous tumor motion management. Stringent dose volume constraints of SBRT require the treatment planning to be highly personalized. Not only the complete patient's medical information (anatomy, tumor size/shape/location/motion, breathing pattern, health status) should be taken into consideration during planning, but also a wide range of factors including imaging techniques (imaging modality, breathing control, immobilization, patient position, etc.), treatment planning techniques (3D-conformal, dynamic conformal arcs, IMRT, VMAT, etc.), image guidance techniques (CBCT, orthogonal X-Ray, fiducial marker tracking, fluoroscopy, etc.), and delivery techniques (FFF, gating, tracking, etc.). In addition, potential pitfalls may exist in SBRT techniques and processes, such as target volume error in 4DCT and image registration error in image guidance. How to manage these affecting factors to achieve optimal, personalized SBRT treatment plans remains a great challenge. In this proposal, we will review technologies, share experiences, and discuss strategies concerning SBRT simulation, planning, and delivery. LEARNING OBJECTIVES 1. Understand requirements and challenges of SBRT treatment planning 2. Discuss information-driven strategies of developing optimal SBRT plans 3. Discuss practical considerations and potential pitfalls of SBRT treatment planning.