Is multileaf collimator tracking or gating a better intrafraction motion adaptation strategy? An analysis of the TROG 15.01 stereotactic prostate ablative radiotherapy with KIM (SPARK) trial.

Hewson, EA; Nguyen, DT; O'Brien, R; Poulsen, PR; Booth, JT; Greer, P; Eade, T; Kneebone, A; Hruby, G; Moodie, T; Hayden, AJ; Turner, SL; Hardcastle, N; Siva, S; Tai, KH; Martin, J; Keall, PJ

Is multileaf collimator tracking or gating a better intrafraction motion adaptation strategy? An analysis of the TROG 15.01 stereotactic prostate ablative radiotherapy with KIM (SPARK) trial.

Hewson, EA Nguyen, DT O'Brien, R Poulsen, PR Booth, JT Greer, P Eade, T Kneebone, A Hruby, G Moodie, T Hayden, AJ Turner, SL Hardcastle, N Siva, S Tai, KH Martin, J Keall, PJ

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Publisher:: ELSEVIER IRELAND LTD
Publication Type:: Journal Article
Citation:: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2020, 151, pp. 234-241
Issue Date:: 2020-10

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Field	Value	Language
dc.contributor.author	Hewson, EA
dc.contributor.author	Nguyen, DT
dc.contributor.author	O'Brien, R
dc.contributor.author	Poulsen, PR
dc.contributor.author	Booth, JT
dc.contributor.author	Greer, P
dc.contributor.author	Eade, T
dc.contributor.author	Kneebone, A
dc.contributor.author	Hruby, G
dc.contributor.author	Moodie, T
dc.contributor.author	Hayden, AJ
dc.contributor.author	Turner, SL
dc.contributor.author	Hardcastle, N
dc.contributor.author	Siva, S
dc.contributor.author	Tai, KH
dc.contributor.author	Martin, J
dc.contributor.author	Keall, PJ
dc.date.accessioned	2021-02-23T20:36:51Z
dc.date.available	2020-08-16
dc.date.available	2021-02-23T20:36:51Z
dc.date.issued	2020-10
dc.identifier.citation	Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2020, 151, pp. 234-241
dc.identifier.issn	0167-8140
dc.identifier.issn	1879-0887
dc.identifier.uri	http://hdl.handle.net/10453/146368
dc.description.abstract	<h4>Purpose</h4>Stereotactic Ablative Radiotherapy (SABR) has recently emerged as a favourable treatment option for prostate cancer patients. With higher doses delivered over fewer fractions, motion adaptation is a requirement for accurate delivery of SABR. This study compared the efficacy of multileaf collimator (MLC) tracking vs. gating as a real-time motion adaptation strategy for prostate SABR patients enrolled in a clinical trial.<h4>Methods</h4>Forty-four prostate cancer patients treated over five fractions in the TROG 15.01 SPARK trial were analysed in this study. Forty-nine fractions were treated using MLC tracking and 166 fractions were treated using beam gating and couch shifts. A time-resolved motion-encoded dose reconstruction method was used to evaluate the dose delivered using each motion adaptation strategy and compared to an estimation of what would have been delivered with no motion adaptation strategy implemented.<h4>Results</h4>MLC tracking and gating both delivered doses closer to the plan compared to when no motion adaptation strategy was used. Differences between MLC tracking and gating were small with differences in the mean discrepancy from the plan of -0.3% (CTV D<sub>98%</sub>), 1.4% (CTV D<sub>2%</sub>), 0.4% (PTV D<sub>95%</sub>), 0.2% (rectum V<sub>30Gy</sub>) and 0.0% (bladder V<sub>30Gy</sub>). On average, 0.5 couch shifts were required per gated fractions with a mean interruption duration of 1.8 ± 2.6 min per fraction treated using gating.<h4>Conclusion</h4>Both MLC tracking and gating were effective strategies at improving the accuracy of the dose delivered to the target and organs at risk. While dosimetric performance was comparable, gating resulted in interruptions to treatment.<h4>Clinical trial registration number</h4>NCT02397317.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ELSEVIER IRELAND LTD
dc.relation.ispartof	Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
dc.relation.isbasedon	10.1016/j.radonc.2020.08.010
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	0299 Other Physical Sciences, 1112 Oncology and Carcinogenesis
dc.subject.classification	Oncology & Carcinogenesis
dc.title	Is multileaf collimator tracking or gating a better intrafraction motion adaptation strategy? An analysis of the TROG 15.01 stereotactic prostate ablative radiotherapy with KIM (SPARK) trial.
dc.type	Journal Article
utslib.citation.volume	151
utslib.location.activity	Ireland
utslib.for	0299 Other Physical Sciences
utslib.for	1112 Oncology and Carcinogenesis
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
dc.date.updated	2021-02-23T20:36:50Z
pubs.publication-status	Published
pubs.volume	151

Abstract:

Purpose

Stereotactic Ablative Radiotherapy (SABR) has recently emerged as a favourable treatment option for prostate cancer patients. With higher doses delivered over fewer fractions, motion adaptation is a requirement for accurate delivery of SABR. This study compared the efficacy of multileaf collimator (MLC) tracking vs. gating as a real-time motion adaptation strategy for prostate SABR patients enrolled in a clinical trial.

Methods

Forty-four prostate cancer patients treated over five fractions in the TROG 15.01 SPARK trial were analysed in this study. Forty-nine fractions were treated using MLC tracking and 166 fractions were treated using beam gating and couch shifts. A time-resolved motion-encoded dose reconstruction method was used to evaluate the dose delivered using each motion adaptation strategy and compared to an estimation of what would have been delivered with no motion adaptation strategy implemented.

Results

MLC tracking and gating both delivered doses closer to the plan compared to when no motion adaptation strategy was used. Differences between MLC tracking and gating were small with differences in the mean discrepancy from the plan of -0.3% (CTV D_98%), 1.4% (CTV D_2%), 0.4% (PTV D_95%), 0.2% (rectum V_30Gy) and 0.0% (bladder V_30Gy). On average, 0.5 couch shifts were required per gated fractions with a mean interruption duration of 1.8 ± 2.6 min per fraction treated using gating.

Conclusion

Both MLC tracking and gating were effective strategies at improving the accuracy of the dose delivered to the target and organs at risk. While dosimetric performance was comparable, gating resulted in interruptions to treatment.

Clinical trial registration number

NCT02397317.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/146368