Lung SBRT is widely utilized in community and academic practice (at least it appears this way to us). Yet, the doses are among the highest and the target among the most mobile of any site we treat. In this study, members of the Radiosurgery Society society were solicited to submit treatment plans for a standardized centrally-located, stage I non-small cell lung cancer (NSCLC) to a web-based platform called ProKnow for plan quality assessment and comparison. Participants downloaded the case's CT and generated contours and treatment plans using their own treatment planning system. Of the 227 submitted plans, the majority used a VMAT technique planned on mostly Eclipse, Monaco, or Pinnacle. The big takeaway was that none of these technical factors really mattered. That means human planning skill was the main source of plan quality variation. In this study, versus in real life, planners were able to see how they compared, where they differed, and what they could do to improve. TBL: Lung SBRT plan quality is highly variable for mostly human reasons, but systems that enable radiation plan benchmarking could go a long way toward improving the quality. Moghanaki, Pract Radiat Oncol 2019


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