- Title
- Real-Time Image Guided Ablative Prostate Cancer Radiation Therapy: Results From the TROG 15.01 SPARK Trial
- Creator
- 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; Martin, Jarad; Hardcastle, N; Siva, S; Tai, KH; Gebski, V
- Relation
- NHMRC.APP1112096 http://purl.org/au-research/grants/nhmrc/1112096 & APP1138807 http://purl.org/au-research/grants/nhmrc/1138807
- Relation
- International Journal of Radiation Oncology Biology Physics Vol. 107, Issue 3, p. 530-538
- Publisher Link
- http://dx.doi.org/10.1016/j.ijrobp.2020.03.014
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2020
- Description
- 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.
- Subject
- prostate cancer; radiation therapy; male; middle aged; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1444365
- Identifier
- uon:42282
- Identifier
- ISSN:0360-3016
- Language
- eng
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