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Article

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

1
Department of Radiation Oncology, Hospital Winterthur, 8400 Winterthur, Switzerland
2
Department of Radiation Oncology, Hirslanden Zurich, 8032 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
These authors contributed equally to this work.
Curr. Oncol. 2022, 29(9), 6314-6324; https://doi.org/10.3390/curroncol29090496
Received: 26 July 2022 / Revised: 22 August 2022 / Accepted: 29 August 2022 / Published: 31 August 2022
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. View Full-Text
Keywords: prostate cancer; prostate motion; radiation therapy; ultra-hypofractionation; stereotactic; IGRT; radiopaque fiducial marker; tracking; PTV margin; MR-based adaptive radiotherapy prostate cancer; prostate motion; radiation therapy; ultra-hypofractionation; stereotactic; IGRT; radiopaque fiducial marker; tracking; PTV margin; MR-based adaptive radiotherapy
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MDPI and ACS Style

Oehler, C.; Roehner, N.; Sumila, M.; Curschmann, J.; Storelli, F.; Zwahlen, D.R.; Schneider, U. Intrafraction Prostate Motion Management for Ultra-Hypofractionated Radiotherapy of Prostate Cancer. Curr. Oncol. 2022, 29, 6314-6324. https://doi.org/10.3390/curroncol29090496

AMA Style

Oehler C, Roehner N, Sumila M, Curschmann J, Storelli F, Zwahlen DR, Schneider U. Intrafraction Prostate Motion Management for Ultra-Hypofractionated Radiotherapy of Prostate Cancer. Current Oncology. 2022; 29(9):6314-6324. https://doi.org/10.3390/curroncol29090496

Chicago/Turabian Style

Oehler, Christoph, Nina Roehner, Marcin Sumila, Jürgen Curschmann, Fabrizio Storelli, Daniel Rudolf Zwahlen, and Uwe Schneider. 2022. "Intrafraction Prostate Motion Management for Ultra-Hypofractionated Radiotherapy of Prostate Cancer" Current Oncology 29, no. 9: 6314-6324. https://doi.org/10.3390/curroncol29090496

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