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Online Adaptive Five-Fraction Ablative Radiotherapy for Prostate Cancer Using a Conventional Linear Accelerator
Juan-Francisco Calvo-Ortega1, Coral Laosa-Bello2, Sandra Moragues-Femenía2
1Hospital Quirónsalud Barcelona, Servicio de Oncología Radioterápica, Barcelona. Spain; Hospital Quirónsalud Málaga, Servicio de Oncología Radioterápica, Málaga. Spain.
Practical Radiation Oncology
|February 14, 2025
Summary
Online adaptive stereotactic body radiation therapy (SBRT) for prostate cancer ensures optimal target coverage. This method is clinically feasible, offering improved prostate coverage compared to conventional image-guided radiation therapy (IGRT).
Area of Science:
- Radiation Oncology
- Medical Physics
Background:
- Prostate cancer management requires precise radiation delivery to maximize tumor control and minimize toxicity.
- Conventional image-guided radiation therapy (IGRT) may face challenges in maintaining optimal target coverage due to anatomical variations.
- Online adaptive radiotherapy offers a potential solution for real-time treatment adjustments.
Purpose of the Study:
- To evaluate the dosimetric outcomes of an online adaptive stereotactic body radiation therapy (SBRT) program for prostate cancer.
- To compare the efficacy of online adaptive SBRT with conventional IGRT for prostate cancer treatment.
Main Methods:
- Online adaptive prostate SBRT using a 5-fraction regimen was implemented with a conventional linear accelerator.
- A daily adaptive "plan-of-the-day" (POD) was generated using CBCT imaging for each fraction.
- Dosimetric analysis included target coverage, organs-at-risk (OARs) sparing, patient-specific quality assurance (PSQA), and treatment timing.
Main Results:
- Online adaptive SBRT achieved optimal prostate coverage in all fractions.
- Conventional IGRT plans failed to provide adequate prostate coverage (V40 Gy ≥ 95%) in 70% of fractions.
- Patient-specific quality assurance demonstrated excellent agreement, and adaptation time averaged 20.1 minutes.
Conclusions:
- The online adaptive SBRT program for prostate cancer is clinically feasible using a conventional linear accelerator.
- This adaptive approach ensures superior target coverage compared to conventional IGRT.
- The program adheres to established clinical trial acceptance criteria.
