Electromagnetic-Guided MLC Tracking Radiation Therapy for Prostate Cancer Patients: Prospective Clinical Trial Results

被引：21

作者：

Keall, Paul J. ^{[1
]}

Colvill, Emma ^{[1
,2
]}

O'Brien, Ricky ^{[1
]}

Caillet, Vincent ^{[1
,2
]}

Eade, Thomas ^{[2
]}

Kneebone, Andrew ^{[2
]}

Hruby, George ^{[2
]}

Poulsen, Per R. ^{[3
]}

Zwan, Benjamin ^{[4
,5
]}

Greer, Peter B. ^{[4
,6
]}

Booth, Jeremy ^{[1
,2
]}

机构：

[1] Univ Sydney, ACRF Image Inst X, Biomed Bldg,C81 Camperdown, Sydney, NSW 2006, Australia

[2] Royal North Shore Hosp, Northern Sydney Canc Ctr, Sydney, NSW, Australia

[3] Aarhus Univ Hosp, Dept Oncol, Aarhus, Denmark

[4] Univ Newcastle, Sch Math & Phys Sci, Newcastle, NSW, Australia

[5] Cent Coast Canc Ctr, Gosford, Australia

[6] Calvary Mater Newcastle, Newcastle, NSW, Australia

来源：

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2018年 / 101卷 / 02期

基金：

澳大利亚国家健康与医学研究理事会;

关键词：

MULTILEAF COLLIMATOR TRACKING; MOVING TARGETS; MOTION; RADIOTHERAPY; MANAGEMENT; ACCURACY; DELIVERY; SYSTEM; GLAND;

D O I：

10.1016/j.ijrobp.2018.01.098

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: To report on the primary and secondary outcomes of a prospective clinical trial of electromagnetic-guided multileaf collimator (MLC) tracking radiation therapy for prostate cancer. Methods and Materials: Twenty-eight men with prostate cancer were treated with electromagnetic-guided MLC tracking with volumetric modulated arc therapy. A total of 858 fractions were delivered, with the dose per fraction ranging from 2 to 13.75 Gy. The primary outcome was feasibility, with success determined if > 95% of fractions were successfully delivered. The secondary outcomes were (1) the improvement in beam-target geometric alignment, (2) the improvement in dosimetric coverage of the prostate and avoidance of critical structures, and (3) no acute grade >= 3 genitourinary or gastrointestinal toxicity. Results: All 858 planned fractions were successfully delivered with MLC tracking, demonstrating the primary outcome of feasibility (P<.001). MLC tracking improved the beam-target geometric alignment from 1.4 to 0.90 mm (root-mean-square error). MLC tracking improved the dosimetric coverage of the prostate and reduced the daily variation in dose to critical structures. No acute grade >= 3 genitourinary or gastrointestinal toxicity was observed. Conclusions: Electromagnetic-guided MLC tracking radiation therapy for prostate cancer is feasible. The patients received improved geometric targeting and delivered dose distributions that were closer to those planned than they would have received without electromagnetic-guided MLC tracking. No significant acute toxicity was observed. (C) 2018 Elsevier Inc. All rights reserved.

引用

页码：387 / 395

页数：9

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