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

Authors

Samuel T. Chao, Department of Radiation Oncology, Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland.
Aviva Berkowitz, Department of Radiation Medicine, Westchester Medical Center, New York Medical College, Valhalla.
Eleanor E. Harris, Department of Radiation Oncology, St. Luke's University Health Network Cancer Center, Cancer Center Administration, Easton, PA.
Mark A. Henderson, Department of Radiation Oncology, Columbus Regional Hospital, Columbus, IN.
Simon S. Lo, Department of Radiation Oncology, University of Washington Medical Center, Fred Hutch Cancer Center, Seattle, WA.
Matthew Pacella, Department of Radiation Oncology, University of Rochester Medical Center, Wilmot Cancer Institute, Rochester.
Joshua Palmer, Department of Radiation Oncology, The James Cancer Hospital at The Ohio State University Wexner Medical Center, The Ohio State University, Columbus, OH.
Hina Saeed, Department of Radiation Oncology, Florida International University, Lynn Cancer Institute, Baptist Health Cancer Care, Boca Raton.
Charles B. Simone, New York Proton Center, Radiation Oncology, New York, NY.
Benjamin P. Ziemer, University of Southern California, Los Angeles, CA.
William Small, Department of Radiation Oncology, Stritch School of Medicine, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL.
Naomi R. Schechter, South Florida Proton Therapy Institute, Delray Beach, FL.

Author Type(s)

Faculty

DOI

10.1097/COC.0000000000001224

Journal Title

American Journal of Clinical Oncology

First Page

1

Last Page

9

Document Type

Article

Publication Date

1-1-2026

Department

Radiation Medicine

Keywords

guidelines, practice parameters, quality, stereotactic body radiation therapy

Disciplines

Medicine and Health Sciences

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.

Recommended Citation

Chao, S. T., Berkowitz, A., Harris, E. E., Henderson, M. A., Lo, S. S., Pacella, M., Palmer, J., Saeed, H., Simone, C. B., Ziemer, B. P., Small, W., & Schechter, N. R. (2026). ACR-ARS Practice Parameter for the Performance of Stereotactic Body Radiation Therapy. American Journal of Clinical Oncology, 49 (1), 1-9. https://doi.org/10.1097/COC.0000000000001224