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Practice Guideline
. 2026 Jan 1;49(1):1-9.
doi: 10.1097/COC.0000000000001224. Epub 2025 Jun 23.

ACR-ARS Practice Parameter for the Performance of Stereotactic Body Radiation Therapy

Samuel T Chao  1 , Aviva Berkowitz  2 , Eleanor E R Harris  3 , Mark A Henderson  4 , Simon S Lo  5 , Matthew Pacella  6 , Joshua Palmer  7 , Hina Saeed  8 , Charles B Simone 2nd  9 , Benjamin P Ziemer  10 , William Small Jr  11 , Naomi R Schechter  12
Affiliations
Practice Guideline

ACR-ARS Practice Parameter for the Performance of Stereotactic Body Radiation Therapy

Samuel T Chao et al. Am J Clin Oncol. .

Abstract

Objectives: This practice parameter was revised collaboratively by the American College of Radiology (ACR) and American Radium Society (ARS). Stereotactic body radiation therapy (SBRT) precisely delivers higher dose(s) of radiation in 5 of fewer fractions, compared with conventional radiation. Given the complexity and technical nature of this treatment technique, practice parameters are needed to provide guidance to physicians and physicists.

Methods: This practice parameter was developed according to the process described under the heading The Process for Developing ACR Practice Parameters and Technical Standards on the ACR website ( https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards ) by the Committee on Practice Parameters-Radiation Oncology of the ACR Commission on Radiation Oncology in collaboration with the ARS.

Results: Workflow, qualifications/responsibilities of personnel, quality control, and treatment delivery/verification are reviewed. Notable elements of SBRT include image guidance, immobilization, and motion management, with the treatment planning goal of minimizing the volume of normal tissue exposed to medium and high dose levels and maximizing dose safely to the target. Specialized training is encouraged, as some technologies are not used in standard treatments.

Conclusions: This practice parameter provides direction on key components recommended for SBRT and may be used as a guide to physicians and physicists wanting to provide this treatment to their patients.

Keywords: guidelines; practice parameters; quality; stereotactic body radiation therapy.

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Conflict of interest statement

S.T.C.: Honorarium - Varian Medical Systems. S.S.L. declares that he was a coprincipal investigator on a research project funded by the Kuni Foundation and has received research funding in this capacity. He also serves as a member of the lead academic participating site for the Hutchinson Center under the NIH-funded grant UG1 CA 233328. Moreover, he serves as a member of the Board of Directors for the Radiosurgery Society and as the Medical Director of Distinction in the Stereotactic Radiotherapy Accreditation Program. In addition, he is a Councilor of the American College of Radiology (ACR) and Chair of the Nominating Committee of the Council of Affiliated Regional Radiation Oncology Societies of ACR. J.P.: Genentech research funding, Servier advisory board, ICOTEC consultant, Spine Therapy Society- Founding Board Member, Varian Medical Systems- Honorarium, DiscoverDx- Honorarium. N.R.S.: South Florida Proton Therapy Institute, Radiation Oncologist. Volunteer relationships: American College of Radiology, Immediate Past Chair of Practice Parameters, Radiation Oncology, Chair of CARROS Quality and Safety Committee, and CARROS Secretary; ASTRO, Chair of Patient Safety Scientific Committee. The other authors declare no conflicts of interest.

References

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