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

Keall, P; Nguyen, DT; O'Brien, R; Hewson, E; Ball, H; Poulsen, P; Booth, J; Greer, P; Hunter, P; Wilton, L; Bromley, R; Kipritidis, J; Eade, T; Kneebone, A; Hruby, G; Moodie, T; Hayden, A; Turner, S; Arumugam, S; Sidhom, M; Hardcastle, N; Siva, S; Tai, K-H; Gebski, V; Martin, J

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

Keall, P Nguyen, DT O'Brien, R Hewson, E Ball, H Poulsen, P Booth, J Greer, P Hunter, P Wilton, L Bromley, R Kipritidis, J Eade, T Kneebone, A Hruby, G Moodie, T Hayden, A Turner, S Arumugam, S Sidhom, M Hardcastle, N Siva, S Tai, K-H Gebski, V Martin, J

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Publisher:: ELSEVIER SCIENCE INC
Publication Type:: Journal Article
Citation:: International journal of radiation oncology, biology, physics, 2020, 107, (3), pp. 530-538
Issue Date:: 2020-07

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Field	Value	Language
dc.contributor.author	Keall, P
dc.contributor.author	Nguyen, DT
dc.contributor.author	O'Brien, R
dc.contributor.author	Hewson, E
dc.contributor.author	Ball, H
dc.contributor.author	Poulsen, P
dc.contributor.author	Booth, J
dc.contributor.author	Greer, P
dc.contributor.author	Hunter, P
dc.contributor.author	Wilton, L
dc.contributor.author	Bromley, R
dc.contributor.author	Kipritidis, J
dc.contributor.author	Eade, T
dc.contributor.author	Kneebone, A
dc.contributor.author	Hruby, G
dc.contributor.author	Moodie, T
dc.contributor.author	Hayden, A
dc.contributor.author	Turner, S
dc.contributor.author	Arumugam, S
dc.contributor.author	Sidhom, M
dc.contributor.author	Hardcastle, N
dc.contributor.author	Siva, S
dc.contributor.author	Tai, K-H
dc.contributor.author	Gebski, V
dc.contributor.author	Martin, J
dc.date.accessioned	2021-03-23T01:19:52Z
dc.date.available	2021-08-12T19:01:04Z
dc.date.issued	2020-07
dc.identifier.citation	International journal of radiation oncology, biology, physics, 2020, 107, (3), pp. 530-538
dc.identifier.issn	0360-3016
dc.identifier.issn	1879-355X
dc.identifier.uri	http://hdl.handle.net/10453/147463
dc.description.abstract	<h4>Purpose</h4>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.<h4>Methods and materials</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>Real-time IGRT is clinically effective for prostate cancer SABR.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ELSEVIER SCIENCE INC
dc.relation	http://purl.org/au-research/grants/nhmrc/GNT1138807
dc.relation.ispartof	International journal of radiation oncology, biology, physics
dc.relation.isbasedon	10.1016/j.ijrobp.2020.03.014
dc.rights	info:eu-repo/semantics/embargoedAccess
dc.subject	0299 Other Physical Sciences, 1103 Clinical Sciences, 1112 Oncology and Carcinogenesis
dc.subject.classification	Oncology & Carcinogenesis
dc.subject.mesh	Ablation Techniques
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Prostatic Neoplasms
dc.subject.mesh	Radiotherapy, Intensity-Modulated
dc.subject.mesh	Time Factors
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Humans
dc.subject.mesh	Prostatic Neoplasms
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Time Factors
dc.subject.mesh	Middle Aged
dc.subject.mesh	Male
dc.subject.mesh	Radiotherapy, Intensity-Modulated
dc.subject.mesh	Ablation Techniques
dc.subject.mesh	Ablation Techniques
dc.subject.mesh	Humans
dc.subject.mesh	Male
dc.subject.mesh	Middle Aged
dc.subject.mesh	Prostatic Neoplasms
dc.subject.mesh	Radiotherapy, Intensity-Modulated
dc.subject.mesh	Time Factors
dc.subject.mesh	Treatment Outcome
dc.title	Real-Time Image Guided Ablative Prostate Cancer Radiation Therapy: Results From the TROG 15.01 SPARK Trial.
dc.type	Journal Article
utslib.citation.volume	107
utslib.location.activity	United States
utslib.for	0299 Other Physical Sciences
utslib.for	1103 Clinical Sciences
utslib.for	1112 Oncology and Carcinogenesis
pubs.organisational-group	/University of Technology Sydney
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
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2021-03-23T01:19:50Z
pubs.issue	3
pubs.publication-status	Published
pubs.volume	107
utslib.citation.issue	3

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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http://hdl.handle.net/10453/147463