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

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 ( vs 15 in 2012) indicated they had an active SABR programme with the remaining 12 centres intending to develop a SABR programme Documented changes include the development of Linac delivered SABR to non-lung sites, an increase in centres using abdominal compression (14 vs 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.