Consensus-based organizational guideline for the planning and delivery of spine stereotactic body radiotherapy treatment in Ontario

Guideline Objective

The objective of this organizational guideline is to ensure that cancer centres across Ontario have guidance as to how spine stereotactic body radiotherapy (SBRT) should be administered with the intent to minimize side effects and maximize patient safety. The administration of spine SBRT also includes the surveillance of SBRT patients post-SBRT, with both clinical and imaging follow-up practices as an essential practice for patient safety.

Patient Population

All cancer adult patients (>18) with spinal metastasis who are eligible to receive treatment with SBRT.

Intended Guideline Users

Stakeholders include all Ontario Regional Cancer Programs that currently deliver, or planning spine SBRT. Specifically, in these Cancer Programs this guideline is intended for:

1. Clinicians involved in the organization and delivery of spine SBRT in Ontario.
2. Administrators involved in the organization and delivery of care of patients with spinal metastasis who are eligible for spine SBRT in Ontario.

Research Questions

What are the optimal organizational standards for the safe delivery of spine SBRT to adult cancer patients with spinal metastases in Ontario with respect to:

1. Multidisciplinary teams responsible for the delivery of spine SBRT
2. Equipment/imaging requirements for simulation and delivery of spine SBRT
3. QA of the treatment and treatment unit
4. Post-spine SBRT imaging follow-up.