Real-Time Image-Guided Ablative Prostate Cancer Radiation Therapy: Results from the TROG 15.01 SPARK Trial
Abstract
PURPOSE
Kilovoltage Intrafraction Monitoring (KIM) is a novel software platform implemented on standard radiation therapy systems 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 prostate cancer patients received during radiation therapy.
METHODS AND MATERIALS
Forty-eight patients with prostate cancer were treated with KIM-guided Stereotactic Ablative Radiation Therapy (SABR) with 36.25 Gy in five 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 (42/48) and 51% of treatments (121/235). With real-time IGRT, no treatments had prostate 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 show no change in the 12-month patient reported outcomes compared with baseline and no grade ≥3 GU or GI toxicities.…
Read the paper
Related studies
- Lathyrism-induced alterations in collagen cross-links influence the mechanical properties of bone material without affecting the mineral
- High-Resolution SPECT-CT/MR Molecular Imaging of Angiogenesis in the Vx2 Model
- Severely impaired bone material quality in Chihuahua zebrafish resembles classical dominant human osteogenesis imperfecta
- Small-animal SPECT and SPECT/CT: application in cardiovascular research
- Intravital imaging of osteocytes in mouse calvaria using third harmonic generation microscopy
- Techniques and Evaluation From a Cross-Platform Imaging Comparison of Quantitative Ultrasound Parameters in an In Vivo Rodent Fibroadenoma Model
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.