Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
The University of Sydney, Sydney, NSW, Australia.
BMC Cancer. 2021 May 3;21(1):494. doi: 10.1186/s12885-021-08184-x.
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.
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.
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.
This trial was registered on December 7th 2016 on ClinicalTrials.gov under the trial-ID NCT02984566 .
立体定向消融体放射治疗（SABR）是一种非侵入性治疗方法，能够以高精度和高精准度提供消融剂量。SABR 是原发性和继发性肝恶性肿瘤的既定治疗方法，技术进步提高了其疗效和安全性。为了减少肿瘤运动并实现靶向准确性，呼吸运动管理和图像引导是肝 SABR 的关键要素。这项由 TROG 17.03 进行的多机构二期研究，即使用千伏实时成像引导的肝消融放疗（LARK），旨在研究和评估 KIM 实时图像引导技术的剂量学影响。KIM 利用标准的线性加速器设备，因此有可能成为肝 SABR 的一种广泛可用的实时图像引导技术。
该研究将纳入 46 例适合并接受 KIM 引导的立体定向消融体放射治疗（SABR）治疗的肝细胞癌或寡转移性肝肿瘤患者。将通过量化有或没有 KIM 干预的累积患者剂量分布来评估剂量学影响。将测量患者的局部控制、毒性和生活质量的治疗结果。
肝 SABR 是一种非常有效的治疗方法，但由于器官运动，精确的剂量输送具有挑战性。目前，缺乏广泛可用的实时肿瘤定位选项来协助肝 SABR 的准确输送。本研究将评估 KIM 作为肝 SABR 实时图像引导的潜在解决方案的影响。
该试验于 2016 年 12 月 7 日在 ClinicalTrials.gov 上注册，试验编号为 NCT02984566。
