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Use of Motion Management to Model Unmanaged Motion: Dosimetric Consequences of Unmanaged Prostate Motion Assessed

Scott B Crowe^1,2,3, Jemma Walsh¹, Gregory Rattray¹

¹Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, AUS.

|May 21, 2025

Summary

Real-time adaptation using Radixact Synchrony significantly improved prostate cancer radiotherapy accuracy by managing intrafraction motion. This system prevented compromised target coverage and potential underdosage, especially crucial for stereotactic body radiotherapy (SBRT).

Keywords:

motion management prostate cancer radiotherapy real-time tracking tomotherapy

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Area of Science:

Radiation Oncology
Medical Physics
Image-Guided Therapy

Background:

Prostate motion during radiotherapy can compromise treatment accuracy.
Real-time adaptation systems aim to mitigate intrafraction motion effects.
Continuous target drift combined with couch motion poses significant challenges.

Observation:

A case report analyzed intrafraction prostate motion data from the Radixact Synchrony system.
The selected patient exhibited high levels of continuous target drift.
Data were used to simulate treatment delivery with and without real-time adaptation.

Findings:

Without Synchrony, target coverage was compromised in standard hypofractionated radiotherapy.
Real-time adaptation ensured adequate target coverage for the analyzed patient.
Simulations suggested unacceptable underdosage with stereotactic body radiotherapy (SBRT) without real-time adaptation.

Implications:

Real-time adaptation systems like Radixact Synchrony are crucial for accurate prostate radiotherapy.
The benefits are particularly pronounced for ultra-hypofractionated SBRT regimens.
This technology enhances treatment efficacy and patient outcomes by precisely managing intrafraction motion.