A dosimetric comparison of real-time adaptive and non-adaptive radiotherapy: A multi-institutional study encompassing robotic, gimbaled, multileaf collimator and couch tracking. Issue 1 (April 2016)

• Record Type: Journal Article
• Authors: Colvill, Emma; Booth, Jeremy; Nill, Simeon; Fast, Martin; Bedford, James; Oelfke, Uwe; Nakamura, Mitsuhiro; Poulsen, Per; Worm, Esben; Hansen, Rune; Ravkilde, Thomas; Scherman Rydhög, Jonas; Pommer, Tobias; Munck af Rosenschold, Per; Lang, Stephanie; Guckenberger, Matthias; Groh, Christian; Herrmann, Christian; Verellen, Dirk; Poels, Kenneth; Wang, Lei; Hadsell, Michael; Sothmann, Thilo; Blanck, Oliver; Keall, Paul
• Is Part Of: Radiotherapy and oncology. Volume 119:Issue 1(2016:Apr.)
• Page Start: 159
• Page End: 165
• Publication Date: 2016-04
• Subjects: Robotic tracking -- Gimbaled tracking -- MLC tracking -- Couch tracking -- Organ motion; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2016.03.006
• Languages: English
• ISSNs: 0167-8140

Abstract

Abstract: Purpose: A study of real-time adaptive radiotherapy systems was performed to test the hypothesis that, across delivery systems and institutions, the dosimetric accuracy is improved with adaptive treatments over non-adaptive radiotherapy in the presence of patient-measured tumor motion. Methods and materials: Ten institutions with robotic(2), gimbaled(2), MLC(4) or couch tracking(2) used common materials including CT and structure sets, motion traces and planning protocols to create a lung and a prostate plan. For each motion trace, the plan was delivered twice to a moving dosimeter; with and without real-time adaptation. Each measurement was compared to a static measurement and the percentage of failed points for γ-tests recorded. Results: For all lung traces all measurement sets show improved dose accuracy with a mean 2%/2 mm γ-fail rate of 1.6% with adaptation and 15.2% without adaptation ( p < 0.001). For all prostate the mean 2%/2 mm γ-fail rate was 1.4% with adaptation and 17.3% without adaptation ( p < 0.001). The difference between the four systems was small with an average 2%/2 mm γ-fail rate of <3% for all systems with adaptation for lung and prostate. Conclusions: The investigated systems all accounted for realistic tumor motion accurately and performed to a similar high standard, with real-time adaptation significantly outperforming non-adaptive delivery methods.