Study protocol of the LARK (TROG 17.03) clinical trial: a phase II trial investigating the dosimetric impact of Liver Ablative Radiotherapy using Kilovoltage intrafraction monitoring

Lee, YYD; Nguyen, DT; Moodie, T; O’Brien, R; McMaster, A; Hickey, A; Pritchard, N; Poulsen, P; Tabaksblat, EM; Weber, B; Worm, E; Pryor, D; Chu, J; Hardcastle, N; Booth, J; Gebski, V; Wang, T; Keall, P

Study protocol of the LARK (TROG 17.03) clinical trial: a phase II trial investigating the dosimetric impact of Liver Ablative Radiotherapy using Kilovoltage intrafraction monitoring

Lee, YYD Nguyen, DT Moodie, T O’Brien, R McMaster, A Hickey, A Pritchard, N Poulsen, P Tabaksblat, EM Weber, B Worm, E Pryor, D Chu, J Hardcastle, N Booth, J Gebski, V Wang, T Keall, P

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Publisher:: Springer Science and Business Media LLC
Publication Type:: Journal Article
Citation:: BMC Cancer, 2021, 21, (1), pp. 494
Issue Date:: 2021-05-03

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Field	Value	Language
dc.contributor.author	Lee, YYD
dc.contributor.author	Nguyen, DT
dc.contributor.author	Moodie, T
dc.contributor.author	O’Brien, R
dc.contributor.author	McMaster, A
dc.contributor.author	Hickey, A
dc.contributor.author	Pritchard, N
dc.contributor.author	Poulsen, P
dc.contributor.author	Tabaksblat, EM
dc.contributor.author	Weber, B
dc.contributor.author	Worm, E
dc.contributor.author	Pryor, D
dc.contributor.author	Chu, J
dc.contributor.author	Hardcastle, N
dc.contributor.author	Booth, J
dc.contributor.author	Gebski, V
dc.contributor.author	Wang, T
dc.contributor.author	Keall, P
dc.date.accessioned	2022-03-18T04:44:54Z
dc.date.available	2021-04-13
dc.date.available	2022-03-18T04:44:54Z
dc.date.issued	2021-05-03
dc.identifier.citation	BMC Cancer, 2021, 21, (1), pp. 494
dc.identifier.issn	1471-2407
dc.identifier.issn	1471-2407
dc.identifier.uri	http://hdl.handle.net/10453/155340
dc.description.abstract	BACKGROUND: Stereotactic Ablative Body Radiotherapy (SABR) is a non-invasive treatment which allows delivery of an ablative radiation dose with high accuracy and precision. SABR is an established treatment for both primary and secondary liver malignancies, and technological advances have improved its efficacy and safety. Respiratory motion management to reduce tumour motion and image guidance to achieve targeting accuracy are crucial elements of liver SABR. This phase II multi-institutional TROG 17.03 study, Liver Ablative Radiotherapy using Kilovoltage intrafraction monitoring (LARK), aims to investigate and assess the dosimetric impact of the KIM real-time image guidance technology. KIM utilises standard linear accelerator equipment and therefore has the potential to be a widely available real-time image guidance technology for liver SABR. METHODS: Forty-six patients with either hepatocellular carcinoma or oligometastatic disease to the liver suitable for and treated with SABR using Kilovoltage Intrafraction Monitoring (KIM) guidance will be included in the study. The dosimetric impact will be assessed by quantifying accumulated patient dose distribution with or without the KIM intervention. The patient treatment outcomes of local control, toxicity and quality of life will be measured. DISCUSSION: Liver SABR is a highly effective treatment, but precise dose delivery is challenging due to organ motion. Currently, there is a lack of widely available options for performing real-time tumour localisation to assist with accurate delivery of liver SABR. This study will provide an assessment of the impact of KIM as a potential solution for real-time image guidance in liver SABR. TRIAL REGISTRATION: This trial was registered on December 7th 2016 on ClinicalTrials.gov under the trial-ID NCT02984566 .
dc.format	Electronic
dc.language	eng
dc.publisher	Springer Science and Business Media LLC
dc.relation.ispartof	BMC Cancer
dc.relation.isbasedon	10.1186/s12885-021-08184-x
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1112 Oncology and Carcinogenesis, 1117 Public Health and Health Services
dc.subject.classification	Oncology & Carcinogenesis
dc.subject.mesh	Australia
dc.subject.mesh	Carcinoma, Hepatocellular
dc.subject.mesh	Denmark
dc.subject.mesh	Fiducial Markers
dc.subject.mesh	Humans
dc.subject.mesh	Liver Neoplasms
dc.subject.mesh	Organ Motion
dc.subject.mesh	Quality of Life
dc.subject.mesh	Radiosurgery
dc.subject.mesh	Radiotherapy Dosage
dc.subject.mesh	Radiotherapy Planning, Computer-Assisted
dc.subject.mesh	Radiotherapy, Image-Guided
dc.subject.mesh	Radiotherapy, Intensity-Modulated
dc.subject.mesh	Respiration
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Humans
dc.subject.mesh	Carcinoma, Hepatocellular
dc.subject.mesh	Liver Neoplasms
dc.subject.mesh	Treatment Outcome
dc.subject.mesh	Radiosurgery
dc.subject.mesh	Radiotherapy Dosage
dc.subject.mesh	Radiotherapy Planning, Computer-Assisted
dc.subject.mesh	Respiration
dc.subject.mesh	Quality of Life
dc.subject.mesh	Australia
dc.subject.mesh	Denmark
dc.subject.mesh	Radiotherapy, Intensity-Modulated
dc.subject.mesh	Fiducial Markers
dc.subject.mesh	Radiotherapy, Image-Guided
dc.subject.mesh	Organ Motion
dc.title	Study protocol of the LARK (TROG 17.03) clinical trial: a phase II trial investigating the dosimetric impact of Liver Ablative Radiotherapy using Kilovoltage intrafraction monitoring
dc.type	Journal Article
utslib.citation.volume	21
utslib.location.activity	England
utslib.for	1112 Oncology and Carcinogenesis
utslib.for	1117 Public Health and Health Services
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	*
dc.date.updated	2022-03-18T04:44:51Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	21
utslib.citation.issue	1

Abstract:

BACKGROUND: Stereotactic Ablative Body Radiotherapy (SABR) is a non-invasive treatment which allows delivery of an ablative radiation dose with high accuracy and precision. SABR is an established treatment for both primary and secondary liver malignancies, and technological advances have improved its efficacy and safety. Respiratory motion management to reduce tumour motion and image guidance to achieve targeting accuracy are crucial elements of liver SABR. This phase II multi-institutional TROG 17.03 study, Liver Ablative Radiotherapy using Kilovoltage intrafraction monitoring (LARK), aims to investigate and assess the dosimetric impact of the KIM real-time image guidance technology. KIM utilises standard linear accelerator equipment and therefore has the potential to be a widely available real-time image guidance technology for liver SABR. METHODS: Forty-six patients with either hepatocellular carcinoma or oligometastatic disease to the liver suitable for and treated with SABR using Kilovoltage Intrafraction Monitoring (KIM) guidance will be included in the study. The dosimetric impact will be assessed by quantifying accumulated patient dose distribution with or without the KIM intervention. The patient treatment outcomes of local control, toxicity and quality of life will be measured. DISCUSSION: Liver SABR is a highly effective treatment, but precise dose delivery is challenging due to organ motion. Currently, there is a lack of widely available options for performing real-time tumour localisation to assist with accurate delivery of liver SABR. This study will provide an assessment of the impact of KIM as a potential solution for real-time image guidance in liver SABR. TRIAL REGISTRATION: This trial was registered on December 7th 2016 on ClinicalTrials.gov under the trial-ID NCT02984566 .

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