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Real-Time Image Guided Ablative Prostate Cancer Radiation Therapy: Results From the TROG 15.01 SPARK Trial.
Keall, Paul; Nguyen, Doan Trang; O'Brien, Ricky; Hewson, Emily; Ball, Helen; Poulsen, Per; Booth, Jeremy; Greer, Peter; Hunter, Perry; Wilton, Lee; Bromley, Regina; Kipritidis, John; Eade, Thomas; Kneebone, Andrew; Hruby, George; Moodie, Trevor; Hayden, Amy; Turner, Sandra; Arumugam, Sankar; Sidhom, Mark; Hardcastle, Nicholas; Siva, Shankar; Tai, Keen-Hun; Gebski, Val; Martin, Jarad.
Affiliation
  • Keall P; ACRF Image X Institute, University of Sydney, Sydney, Australia. Electronic address: paul.keall@sydney.edu.au.
  • Nguyen DT; ACRF Image X Institute, University of Sydney, Sydney, Australia; School of Biomedical Engineering, University of Technology, Sydney, Sydney, Australia.
  • O'Brien R; ACRF Image X Institute, University of Sydney, Sydney, Australia.
  • Hewson E; ACRF Image X Institute, University of Sydney, Sydney, Australia.
  • Ball H; ACRF Image X Institute, University of Sydney, Sydney, Australia.
  • Poulsen P; Department of Oncology and Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark.
  • Booth J; Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia; School of Physics, University of Sydney, Sydney, Australia.
  • Greer P; Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, Australia; University of Newcastle, Newcastle, Australia.
  • Hunter P; Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, Australia.
  • Wilton L; Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, Australia.
  • Bromley R; Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia.
  • Kipritidis J; Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia.
  • Eade T; Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia; Northern Clinical School, University of Sydney, Sydney, Australia.
  • Kneebone A; Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia; Northern Clinical School, University of Sydney, Sydney, Australia.
  • Hruby G; Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia; Northern Clinical School, University of Sydney, Sydney, Australia.
  • Moodie T; Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia.
  • Hayden A; Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia.
  • Turner S; Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia.
  • Arumugam S; Liverpool and Macarthur Cancer Therapy Centres, Liverpool Hospital, Sydney, Australia.
  • Sidhom M; Liverpool and Macarthur Cancer Therapy Centres, Liverpool Hospital, Sydney, Australia.
  • Hardcastle N; Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia; Institute of Medical Physics, University of Sydney, Sydney, Australia.
  • Siva S; Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, University of Melbourne, Australia.
  • Tai KH; Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, University of Melbourne, Australia.
  • Gebski V; NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.
  • Martin J; Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, Australia; University of Newcastle, Newcastle, Australia.
Int J Radiat Oncol Biol Phys ; 107(3): 530-538, 2020 07 01.
Article in En | MEDLINE | ID: mdl-32234553
ABSTRACT

PURPOSE:

Kilovoltage intrafraction monitoring (KIM) is a novel software platform implemented on standard radiation therapy systems and enabling real-time image guided radiation therapy (IGRT). In a multi-institutional prospective trial, we investigated whether real-time IGRT improved the accuracy of the dose patients with prostate cancer received during radiation therapy. METHODS AND MATERIALS Forty-eight patients with prostate cancer were treated with KIM-guided SABR with 36.25 Gy in 5 fractions. During KIM-guided treatment, the prostate motion was corrected for by either beam gating with couch shifts or multileaf collimator tracking. A dose reconstruction method was used to evaluate the dose delivered to the target and organs at risk with and without real-time IGRT. Primary outcome was the effect of real-time IGRT on dose distributions. Secondary outcomes included patient-reported outcomes and toxicity.

RESULTS:

Motion correction occurred in ≥1 treatment for 88% of patients (42 of 48) and 51% of treatments (121 of 235). With real-time IGRT, no treatments had prostate clinical target volume (CTV) D98% dose 5% less than planned. Without real-time IGRT, 13 treatments (5.5%) had prostate CTV D98% doses 5% less than planned. The prostate CTV D98% dose with real-time IGRT was closer to the plan by an average of 1.0% (range, -2.8% to 20.3%). Patient outcomes showed no change in the 12-month patient-reported outcomes compared with baseline and no grade ≥3 genitourinary or gastrointestinal toxicities.

CONCLUSIONS:

Real-time IGRT is clinically effective for prostate cancer SABR.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Prostatic Neoplasms / Radiotherapy, Intensity-Modulated / Ablation Techniques Aspects: Patient_preference Limits: Humans / Male / Middle aged Language: En Journal: Int J Radiat Oncol Biol Phys Year: 2020 Document type: Article
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Prostatic Neoplasms / Radiotherapy, Intensity-Modulated / Ablation Techniques Aspects: Patient_preference Limits: Humans / Male / Middle aged Language: En Journal: Int J Radiat Oncol Biol Phys Year: 2020 Document type: Article