Arumugam Sankar, Young Tony, Jones Catherine, Pryor David, Sidhom Mark
Department of Medical Physics, Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute, Sydney, NSW, Australia.
South Western Clinical School, University of New South Wales, Sydney, NSW, Australia.
Front Oncol. 2024 Aug 9;14:1372968. doi: 10.3389/fonc.2024.1372968. eCollection 2024.
The purpose of this study was to assess the dosimetric improvements achieved in prostate stereotactic body radiotherapy (SBRT) treatment within the PROMETHEUS and NINJA trials using an in-house real-time position monitoring system, SeedTracker.
This study considered a total of 127 prostate SBRT patients treated in the PROMETHEUS (ACTRN12615000223538) and NINJA (ACTRN12618001806257) clinical trials. The SeedTracker position monitoring system was utilized for real-time position monitoring with a 3-mm position tolerance. The doses delivered to the clinical target volume (CTV), rectum, and bladder were assessed by incorporating the actual target position during treatment. The dose that would have been delivered without monitoring was also assessed by incorporating the observed position deviations.
Treatment with position corrections resulted in a mean (range) CTV D99 difference of -0.3 (-1.0 to 0.0) Gy between the planned and delivered dose. Without corrections, this difference would have been -0.6 (-3.7 to 0.0) Gy. Not correcting for position deviations resulted in a statistically significant difference between the planned and delivered CTV D99 ( < 0.05). The mean (range) dose difference between the planned and delivered D2cc of the rectum and bladder for treatment with position corrections was -0.1 (-3.7 to 4.7) Gy and -0.1 (-1.7 to 0.5) Gy, respectively. Without corrections, these differences would have been -0.6 (-6.1 to 4.7) Gy and -0.2 (-2.5 to 0.9) Gy.
SeedTracker improved clinical dose volume compliance in prostate SBRT. Without monitoring and corrections, delivered dose would significantly differ from the planned dose.
本研究旨在评估在PROMETHEUS和NINJA试验中，使用内部实时位置监测系统SeedTracker在前列腺立体定向体部放射治疗（SBRT）中所实现的剂量学改善。
本研究共纳入了127例在PROMETHEUS（ACTRN12615000223538）和NINJA（ACTRN12618001806257）临床试验中接受前列腺SBRT治疗的患者。SeedTracker位置监测系统用于实时位置监测，位置公差为3毫米。通过纳入治疗期间的实际靶区位置，评估给予临床靶区体积（CTV）、直肠和膀胱的剂量。还通过纳入观察到的位置偏差来评估未进行监测时所给予的剂量。
进行位置校正的治疗使计划剂量与实际给予剂量之间的CTV D99平均（范围）差异为-0.3（-1.0至0.0）Gy。未进行校正时，该差异将为-0.6（-3.7至0.0）Gy。未对位置偏差进行校正导致计划CTV D99与实际给予的CTV D99之间存在统计学显著差异（<0.05）。进行位置校正的治疗中，计划直肠和膀胱D2cc与实际给予剂量之间的平均（范围）剂量差异分别为-0.1（-3.7至4.7）Gy和-0.1（-1.7至0.5）Gy。未进行校正时，这些差异将分别为-0.6（-6.1至4.7）Gy和-0.2（-2.5至0.9）Gy。
SeedTracker改善了前列腺SBRT中的临床剂量体积符合度。未进行监测和校正时，实际给予剂量将与计划剂量有显著差异。
