Real-Time Image Guided Ablative Prostate Cancer Radiation Therapy: Results From the TROG 15.01 SPARK Trial.

Ablation Techniques Humans Male Middle Aged Prostatic Neoplasms / radiotherapy Radiotherapy, Intensity-Modulated Time Factors Treatment Outcome

Journal

International journal of radiation oncology, biology, physics
ISSN: 1879-355X
Titre abrégé: Int J Radiat Oncol Biol Phys
Pays: United States
ID NLM: 7603616

Informations de publication

Date de publication:
01 07 2020
Historique:
received: 06 08 2019
revised: 09 03 2020
accepted: 11 03 2020
pubmed: 3 4 2020
medline: 16 2 2021
entrez: 3 4 2020
Statut: ppublish

Résumé

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. 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. 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. Real-time IGRT is clinically effective for prostate cancer SABR.

Identifiants

DOI: 10.1016/j.ijrobp.2020.03.014 PMID: 32234553
pubmed: 32234553
pii: S0360-3016(20)30937-8
doi: 10.1016/j.ijrobp.2020.03.014
pii:
doi:

Types de publication

Clinical Trial Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

530-538

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Paul Keall (P)

ACRF Image X Institute, University of Sydney, Sydney, Australia. Electronic address: paul.keall@sydney.edu.au.

Doan Trang Nguyen (DT)

ACRF Image X Institute, University of Sydney, Sydney, Australia; School of Biomedical Engineering, University of Technology, Sydney, Sydney, Australia.

Ricky O'Brien (R)

ACRF Image X Institute, University of Sydney, Sydney, Australia.

Emily Hewson (E)

ACRF Image X Institute, University of Sydney, Sydney, Australia.

Helen Ball (H)

ACRF Image X Institute, University of Sydney, Sydney, Australia.

Per Poulsen (P)

Department of Oncology and Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark.

Jeremy Booth (J)

Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia; School of Physics, University of Sydney, Sydney, Australia.

Peter Greer (P)

Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, Australia; University of Newcastle, Newcastle, Australia.

Perry Hunter (P)

Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, Australia.

Lee Wilton (L)

Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, Australia.

Regina Bromley (R)

Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia.

John Kipritidis (J)

Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia.

Thomas Eade (T)

Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia; Northern Clinical School, University of Sydney, Sydney, Australia.

Andrew Kneebone (A)

Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia; Northern Clinical School, University of Sydney, Sydney, Australia.

George Hruby (G)

Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia; Northern Clinical School, University of Sydney, Sydney, Australia.

Trevor Moodie (T)

Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia.

Amy Hayden (A)

Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia.

Sandra Turner (S)

Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia.

Sankar Arumugam (S)

Liverpool and Macarthur Cancer Therapy Centres, Liverpool Hospital, Sydney, Australia.

Mark Sidhom (M)

Liverpool and Macarthur Cancer Therapy Centres, Liverpool Hospital, Sydney, Australia.

Nicholas Hardcastle (N)

Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia; Institute of Medical Physics, University of Sydney, Sydney, Australia.

Shankar Siva (S)

Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, University of Melbourne, Australia.

Keen-Hun Tai (KH)

Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, University of Melbourne, Australia.

Val Gebski (V)

NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.

Jarad Martin (J)

Department of Radiation Oncology, Calvary Mater Newcastle Hospital, Newcastle, Australia; University of Newcastle, Newcastle, Australia.

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Classifications MeSH

questionsmedicales.fr › Procédures de chirurgie opératoire › Techniques d'ablation › Real-Time Image Guided Ablative Prostate...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Real-Time Image Guided Ablative Prostate...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Real-Time Image Guided Ablative Prostate...
questionsmedicales.fr › Maladies urogénitales › Tumeurs de l'appareil urogénital › Tumeurs de l'appareil génital mâle › Tumeurs de la prostate › Real-Time Image Guided Ablative Prostate...
questionsmedicales.fr › Sciences de l'information › Informatique › Informatique médicale › Applications de l'informatique médicale › Prise de décision assistée par ordinateur › Thérapie assistée par ordinateur › Radiothérapie assistée par ordinateur › Radiothérapie conformationnelle › Radiothérapie conformationnelle avec modulation d'intensité › Real-Time Image Guided Ablative Prostate...
questionsmedicales.fr › Phénomènes physiques › Temps › Facteurs temps › Real-Time Image Guided Ablative Prostate...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Real-Time Image Guided Ablative Prostate...