ONLINE ADAPTIVE FIVE-FRACTION ABLATIVE RADIOTHERAPY FOR PROSTATE CANCER USING A CONVENTIONAL LINEAR ACCELERATOR.

IF 3.4 3区 医学 Q2 ONCOLOGY
Juan-Francisco Calvo-Ortega, Coral Laosa-Bello, Sandra Moragues-Femenía, José Torices-Caballero, Miguel Pozo-Massó, Adam Jones, Marcelino Hermida-López
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引用次数: 0

Abstract

Aim: To assess the dosimetric results of an online adaptive stereotactic body radiotherapy (SBRT) program to treat patients with prostate cancer using a conventional linear accelerator.

Methods and materials: Prostate SBRT with five fractions is performed at the XXXX using an online adaptive method previously described (XXXX). A CBCT based adaptive "plan-of-the-day" (POD) is generated for each treatment fraction, which consists of a single volumetric modulated arc therapy. A dosimetric evaluation of the PODs was performed for the first twenty patients and included analysis of the target (prostate), organs-at-risks (OARs), and patient-specific quality assurance (PSQA). Each of the PODs was also compared with the corresponding conventional image-guided radiotherapy (IGRT) method. Finally, the adaptive treatment timing is analyzed for the one hundred PODs in this study RESULTS: The online adaptive treatment method ensured optimal target coverage in all treatment fractions for all patients. However, the simulated IGRT plans did not result in adequate prostate coverage (V40 Gy ≥ 95%) in 70% of fractions. Small average differences between PODs and IGRT plans were found in the OARs. The dose sparing in the rectum and bladder provided by some simulated IGRT plans, was associated with a compromised prostate coverage. The PSQA resulted in an excellent agreement between the online-calculated plans and the independent dose checks performed for all one hundred PODs. The average duration of the plan adaptation was 20.1 ± 6.1 minutes and the average overall session time including adaptation and treatment delivery was 26.4 ± 33.2 minutes.

Conclusions: This study demonstrates The online adaptive program using a conventional linac to treat prostate cancer described in this study is clinically feasible and in adherence with the acceptance criteria set by the PACE B.

Trial:

目的:评估使用传统直线加速器治疗前列腺癌患者的在线自适应立体定向体放射治疗(SBRT)计划的剂量测定结果:在 XXXX 使用之前描述过的在线自适应方法(XXXX)进行前列腺 SBRT,共分五次。为每个治疗部分生成基于 CBCT 的自适应 "当日计划"(POD),其中包括单次容积调制弧治疗。对前二十名患者的 POD 进行了剂量学评估,包括目标(前列腺)、风险器官(OAR)和患者特定质量保证(PSQA)分析。每个 POD 还与相应的传统图像引导放射治疗 (IGRT) 方法进行了比较。最后,分析了本研究中 100 个 POD 的自适应治疗时机 结果:在线自适应治疗方法确保了所有患者在所有治疗分次中的最佳靶点覆盖率。然而,模拟 IGRT 计划在 70% 的分次治疗中没有实现足够的前列腺覆盖率(V40 Gy ≥ 95%)。POD和IGRT计划在OAR中的平均差异较小。一些模拟 IGRT 方案在直肠和膀胱中提供了剂量疏导,但前列腺覆盖率却受到了影响。PSQA 的结果是,在线计算的计划与对所有 100 个 POD 进行的独立剂量检查结果非常一致。计划适应的平均持续时间为 20.1 ± 6.1 分钟,包括适应和治疗在内的整个疗程的平均时间为 26.4 ± 33.2 分钟:本研究表明,本研究中描述的使用传统linac治疗前列腺癌的在线自适应程序在临床上是可行的,并且符合PACE B.Trial设定的验收标准:
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Practical Radiation Oncology
Practical Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
5.20
自引率
6.10%
发文量
177
审稿时长
34 days
期刊介绍: The overarching mission of Practical Radiation Oncology is to improve the quality of radiation oncology practice. PRO''s purpose is to document the state of current practice, providing background for those in training and continuing education for practitioners, through discussion and illustration of new techniques, evaluation of current practices, and publication of case reports. PRO strives to provide its readers content that emphasizes knowledge "with a purpose." The content of PRO includes: Original articles focusing on patient safety, quality measurement, or quality improvement initiatives Original articles focusing on imaging, contouring, target delineation, simulation, treatment planning, immobilization, organ motion, and other practical issues ASTRO guidelines, position papers, and consensus statements Essays that highlight enriching personal experiences in caring for cancer patients and their families.
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