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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Radiation Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1372968

Treatment accuracy of standard linear accelerator-based prostate SBRT: The delivered dose assessment of patients treated within two major clinical trials using an in-house position monitoring system

Provisionally accepted
Sankar Arumugam Sankar Arumugam 1,2*Tony Young Tony Young 1Catherine Jones Catherine Jones 3David Pryor David Pryor 3Mark Sidhom Mark Sidhom 4
  • 1 Department of Medical Physics, Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute, New South Wales, Australia., Sydney, Australia
  • 2 South Western Clinical School, University of New South Wales, Sydney, New South Wales, Australia, Sydney, Australia
  • 3 Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Australia
  • 4 Department of Radiation Oncology, Liverpool and Macarthur Cancer Therapy Centres, New South Wales, Australia, Sydney, Australia

The final, formatted version of the article will be published soon.

    Background and Purpose: 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 3mm position tolerance. The dose 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.Results: Treatment with position corrections resulted in a mean (range) CTV D99 difference of -0.3 (-1.0 -0.0) Gy between the planned and delivered dose. Without corrections, this difference would have been -0.6 (-3.7 -0.0) Gy. Not correcting for position deviations resulted in a statistically significant difference between the planned and delivered CTV D99 (p<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 -4.7) Gy and -0.1 (-1.7 -0.5) Gy, respectively. Without corrections, these differences would have been -0.6 (-6.1 -4.7) Gy and -0.2 (-2.5 -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.

    Keywords: prostate SBRT, Intrafraction motion, online monitoring, Delivered dose assessment, Protocol compliance

    Received: 19 Jan 2024; Accepted: 19 Jul 2024.

    Copyright: © 2024 Arumugam, Young, Jones, Pryor and Sidhom. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Sankar Arumugam, Department of Medical Physics, Liverpool and Macarthur Cancer Therapy Centres and Ingham Institute, New South Wales, Australia., Sydney, Australia

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.