Quality requirements for stereotactic body radiation therapy (SBRT) in multi-institutional clinical trials

Clinical evidence have shown SBRT to be a tolerable, efficacious, and promising non-invasive therapy. Randomized prospective studies comparing surgery vs. SBRT in early-stage lung cancer are proposed to further investigate the relative survival, quality of life, and cost characteristics of these treatment paradigms. Accreditation and dosimetry requirements were carefully vetted for RTOG SBRT trials. Advanced technologies introduced since have posed additional challenges. This study provides an overview of the quality requirements including those for the recently introduced technologies.