Farshad Foroudi1, Daniel Pham2, Aldo Rolfo2, Mathias Bressel2, Colin I Tang3, Alex Tan4, Sandra Turner5, George Hruby6, Stephen Williams7, Dickon Hayne8, Margot Lehman9, Marketa Skala10, Chakiath C Jose11, Kumar Gogna12, Tomas Kron13. 1. Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia. Electronic address: farshad.foroudi@petermac.org. 2. Peter MacCallum Cancer Centre, Melbourne, Australia. 3. Calvary Mater Newcastle, Newcastle, Australia. 4. Townsville Cancer Centre, Townsville, Australia. 5. Westmead Hospital, Sydney, Australia. 6. Royal Prince Alfred Hospital, Sydney, Australia. 7. Christchurch Hospital, Christchurch, New Zealand. 8. Fremantle Hospital, Perth, Australia. 9. Princess Alexandra Hospital, Brisbane, Australia. 10. Royal Hobart Hospital, Hobart, Australia. 11. Auckland Hospital, Auckland, New Zealand. 12. Mater Centre, Brisbane, Australia. 13. Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia.
Abstract
PURPOSE: To assess whether online adaptive radiotherapy for bladder cancer is feasible across multiple Radiation Oncology departments using different imaging, delivery and recording technology. MATERIALS AND METHODS: A multi-centre feasibility study of online adaptive radiotherapy, using a choice of three "plan of the day", was conducted at 12 departments. Patients with muscle-invasive bladder cancer were included. Departments were activated if part of the pilot study or after a site-credentialing visit. There was real time review of the first two cases from each department. RESULTS: 54 patients were recruited, with 50 proceeding to radiotherapy. There were 43 males and 7 females with a mean age of 78 years. The tumour stages treated included T1 (1 patient), T2 (35), T3 (10) and T4 (4). One patient died of an unrelated cause during radiotherapy. The three adaptive plans were created before the 10th fraction in all cases. In 8 (16%) of the patients, a conventional plan using a 'standard' CTV to PTV margin of 1.5cm was used for one or more fractions where the pre-treatment bladder CTV was larger than any of the three adaptive plans. The bladder CTV extended beyond the PTV on post treatment imaging in 9 (18%) of the 49 patients. CONCLUSIONS: From a technical perspective an online adaptive radiotherapy technique can be instituted in a multi-centre setting. However, without further bladder filling control or imaging, a CTV to PTV margin of 7mm is insufficient.
PURPOSE: To assess whether online adaptive radiotherapy for bladder cancer is feasible across multiple Radiation Oncology departments using different imaging, delivery and recording technology. MATERIALS AND METHODS: A multi-centre feasibility study of online adaptive radiotherapy, using a choice of three "plan of the day", was conducted at 12 departments. Patients with muscle-invasive bladder cancer were included. Departments were activated if part of the pilot study or after a site-credentialing visit. There was real time review of the first two cases from each department. RESULTS: 54 patients were recruited, with 50 proceeding to radiotherapy. There were 43 males and 7 females with a mean age of 78 years. The tumour stages treated included T1 (1 patient), T2 (35), T3 (10) and T4 (4). One patient died of an unrelated cause during radiotherapy. The three adaptive plans were created before the 10th fraction in all cases. In 8 (16%) of the patients, a conventional plan using a 'standard' CTV to PTV margin of 1.5cm was used for one or more fractions where the pre-treatment bladder CTV was larger than any of the three adaptive plans. The bladder CTV extended beyond the PTV on post treatment imaging in 9 (18%) of the 49 patients. CONCLUSIONS: From a technical perspective an online adaptive radiotherapy technique can be instituted in a multi-centre setting. However, without further bladder filling control or imaging, a CTV to PTV margin of 7mm is insufficient.
Authors: Robert A Huddart; Alison Birtle; Lauren Maynard; Mark Beresford; Jane Blazeby; Jenny Donovan; John D Kelly; Tony Kirkbank; Duncan B McLaren; Graham Mead; Clare Moynihan; Raj Persad; Christopher Scrase; Rebecca Lewis; Emma Hall Journal: BJU Int Date: 2017-05-29 Impact factor: 5.588
Authors: Adham Hijab; Boris Tocco; Ian Hanson; Hanneke Meijer; Christina Junker Nyborg; Anders Smedegaard Bertelsen; Robert Jan Smeenk; Gillian Smith; Jeff Michalski; Brian C Baumann; Shaista Hafeez Journal: Front Oncol Date: 2021-02-25 Impact factor: 6.244