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Clinical Experience in Prostate Ultrahypofractionated Radiation Therapy With an Online Adaptive Method
Juan-Francisco Calvo-Ortega1, Sandra Moragues-Femenía1, Coral Laosa-Bello1
1Servicio de Oncología Radioterápica, Hospital Quirónsalud, Barcelona, Spain.
Practical Radiation Oncology
|October 20, 2021
Summary
Online adaptive radiation therapy (oART) for prostate cancer is feasible using a standard C-arm linear accelerator. This method significantly improves prostate cancer treatment coverage without artificial intelligence.
Area of Science:
- Radiation Oncology
- Medical Physics
Background:
- Online adaptive radiation therapy (oART) offers potential for improved treatment accuracy.
- Feasibility of oART using standard C-arm linear accelerators (linacs) for prostate cancer requires investigation.
Purpose of the Study:
- To evaluate the feasibility of a novel online adaptive radiation therapy (oART) method for prostate cancer.
- To assess the efficacy of oART delivered via a C-arm linac without artificial intelligence support.
Main Methods:
- 18 prostate cancer patients underwent oART using a C-arm linac with an ultrahypofractionated (7 x 6.1 Gy) scheme.
- Daily cone beam CT scans were used for manual adaptation of treatment plans, with dosimetric comparison between adapted and non-adapted plans.
Main Results:
- oART significantly improved target coverage (97.1% vs. 90.4%, P < .001) compared to non-adapted plans.
- Without adaptation, optimal prostate coverage was missed in 35% of fractions.
- Adapted plans ensured all organ-at-risk dose constraints were met in all fractions.
Conclusions:
- The described oART technique is technically feasible using a C-arm linac.
- This represents the first clinical experience of oART for prostate cancer involving full replanning on a C-arm linac without AI.
