Intrafraction Prostate Motion Management for Ultra-Hypofractionated Radiotherapy of Prostate Cancer.

Purpose: Determine the time-dependent magnitude of intrafraction prostate displacement and a cutoff for the tracking decision. Methods: Nine patients with localized prostate cancer were treated with ultra-hypofractionated radiotherapy (CyberKnife) with fiducial markers. Exact tract kV/kV imaging was...

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Published in:Current Oncology Vol. 29; no. 9; pp. 6314 - 6325
Main Authors: Oehler, Christoph, Roehner, Nina, Sumila, Marcin, Curschmann, Jürgen, Storelli, Fabrizio, Zwahlen, Daniel Rudolf, Schneider, Uwe
Format: Journal Article
Published: MDPI Sep2022
Online Access:View this record in EBSCOhost
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      dt: Sep2022
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        10.3390/curroncol29090496
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        atl: Intrafraction Prostate Motion Management for Ultra-Hypofractionated Radiotherapy of Prostate Cancer.
      aug:
        au:
          Oehler, Christoph
          Roehner, Nina
          Sumila, Marcin
          Curschmann, Jürgen
          Storelli, Fabrizio
          Zwahlen, Daniel Rudolf
          Schneider, Uwe
        affil: Department of Radiation Oncology, Hospital Winterthur, 8400 Winterthur, Switzerland
      sug:
      ab: Purpose: Determine the time-dependent magnitude of intrafraction prostate displacement and a cutoff for the tracking decision. Methods: Nine patients with localized prostate cancer were treated with ultra-hypofractionated radiotherapy (CyberKnife) with fiducial markers. Exact tract kV/kV imaging was used with an average interval of 19–92 s. A Gaussian distribution was calculated for the x-, y-, and z-directions (σx,y,z). The variation of prostate motion (μσ) was obtained by averaging the patients' specifics, and the safety margin was calculated to be MAB = WYm + WBSs. Results: The calculated PTV safety margins were as follows: at 40 s: 0.55 mm (L/r), 0.85 mm (a/p), and 1.05 mm (s/i); at 60 s: 0.9 mm (L/r), 1.35 mm (a/p), and 1.55 mm (s/i); at 100 s: 1.5 mm (L/r), 2.3 mm (a/p), and 2.6 mm (s/i); at 150 s: 1.9 mm (L/r), 3.1 mm (a/p), and 3.6 mm (s/i); at 200 s: 2.2 mm (L/r), 3.8 mm (a/p), and 4.2 mm (s/i); and at 300 s: 2.6 mm (L/r), 5.3 mm (a/p), and 5.6 mm (s/i). A tracking cutoff of 2.5 min seemed reasonable. In order to achieve an accuracy of < 1 mm, tracking with < 50 s intervals was necessary. Conclusions: For ultra-hypofractionated radiotherapy of the prostate with treatment times > 2.5 min, intrafraction motion management is recommended.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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