Daniel Pham1, Tomas Kron2, Mathias Bressel3, Farshad Foroudi4, Nicholas Hardcastle5, Michal Schneider6, Sally Soteriou7, Jayson Innes7, Shankar Siva8. 1. Department of Radiation Therapy Services, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, Australia. Electronic address: Daniel.Pham@radiotherapy.edu.au. 2. Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. 3. Department of Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Australia. 4. Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Department of Radiation Oncology, Olivia Newton-John Cancer Centre/Austin Health, Melbourne, Australia. 5. Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia. 6. Department of Medical Imaging and Radiation Sciences, Monash University, Melbourne, Australia. 7. Department of Radiation Therapy Services, Peter MacCallum Cancer Centre, Melbourne, Australia. 8. Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia.
Abstract
PURPOSE: Stereotactic ablative body radiation therapy for primary kidney cancer treatment relies on motion management that can quantify both the trajectory of kidney motion and stabilize the patient. A prospective ethics-approved clinical trial of stereotactic treatment to primary kidney targets was conducted at our institution. Our aim was to report on specific kidney tumor motion and the inter- and intrafraction motion as seen on treatment. METHODS AND MATERIALS: Patients with tumor size <5 cm received a dose of 26 Gy in 1 fraction and those with tumor size ≥5 cm received 42 Gy in 3 fractions. All patients underwent a 4-dimensional computed tomography planning scan, immobilized in a dual-vacuum system. A conventional linear accelerator cone beam computed tomography scan was used for pre-, mid-, and posttreatment imaging to verify target position. RESULTS: Between July 2012 and October 2014, 33 targets from 32 consecutive patients (24 males/8 females) were treated. Seventeen targets were prescribed 26 Gy/1 fraction and the remaining 16 targets received 42 Gy/3 fractions. Kidney motion at each of the poles was not affected by the presence of tumor (P = .875), nor was the motion statistically different from the corresponding contralateral kidney pole (P = .909). The mean 3-dimensional displacement of the target at mid- and posttreatment was 1.3 mm (standard deviation ± 1.6) and 1.0 mm (standard deviation ± 1.3), respectively. The maximum displacement in any direction for 95% of the fractions at mid- and posttreatment was ≤3 mm. CONCLUSION: In summary, stereotactic ablative body radiation therapy of primary kidney targets can be accurately delivered on a conventional linear accelerator with protocol that has minimal intrafractional target motion. Published by Elsevier Inc.
PURPOSE: Stereotactic ablative body radiation therapy for primary kidney cancer treatment relies on motion management that can quantify both the trajectory of kidney motion and stabilize the patient. A prospective ethics-approved clinical trial of stereotactic treatment to primary kidney targets was conducted at our institution. Our aim was to report on specific kidney tumor motion and the inter- and intrafraction motion as seen on treatment. METHODS AND MATERIALS: Patients with tumor size <5 cm received a dose of 26 Gy in 1 fraction and those with tumor size ≥5 cm received 42 Gy in 3 fractions. All patients underwent a 4-dimensional computed tomography planning scan, immobilized in a dual-vacuum system. A conventional linear accelerator cone beam computed tomography scan was used for pre-, mid-, and posttreatment imaging to verify target position. RESULTS: Between July 2012 and October 2014, 33 targets from 32 consecutive patients (24 males/8 females) were treated. Seventeen targets were prescribed 26 Gy/1 fraction and the remaining 16 targets received 42 Gy/3 fractions. Kidney motion at each of the poles was not affected by the presence of tumor (P = .875), nor was the motion statistically different from the corresponding contralateral kidney pole (P = .909). The mean 3-dimensional displacement of the target at mid- and posttreatment was 1.3 mm (standard deviation ± 1.6) and 1.0 mm (standard deviation ± 1.3), respectively. The maximum displacement in any direction for 95% of the fractions at mid- and posttreatment was ≤3 mm. CONCLUSION: In summary, stereotactic ablative body radiation therapy of primary kidney targets can be accurately delivered on a conventional linear accelerator with protocol that has minimal intrafractional target motion. Published by Elsevier Inc.
Authors: Nicholas Hardcastle; Olivia Cook; Xenia Ray; Alisha Moore; Kevin L Moore; David Pryor; Alana Rossi; Farshad Foroudi; Tomas Kron; Shankar Siva Journal: Radiat Oncol Date: 2021-08-03 Impact factor: 3.481