Journal
CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY
Volume 44, Issue -, Pages -Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ctro.2023.100692
Keywords
Radiation oncology; Body radiotherapy; Stereotactic; Computer assisted radiotherapy; Computer assisted radiotherapy planning; Pancreatic cancer; Lung cancer
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This study evaluated the feasibility of optical skin surface-guided gating for SBRT treatment, achieving successful breath-hold in 92% of treatments. After three months, no local recurrences or acute grade >= 3 toxicities were observed.
Background and purpose: A novel O-ring gantry can deliver stereotactic body radiation therapy (SBRT) with artificial intelligence-facilitated, CT-guided online plan adaptation. It gates mobile targets by optically monitoring skin surface motion. However, this gating solution has not been clinically validated. We conducted a trial to evaluate the feasibility of optical skin surface-guided gating for patients with mobile upper abdominal or lower thoracic malignancies treated with SBRT on this platform (NCT05030454).Materials and methods: Ten patients who were prescribed SBRT to a thoracic or abdominal target and were capable of breath-hold for at least 17 s enrolled. They received SBRT in five fractions with breath-hold technique and optical skin surface motion monitored-gating with a +/- 2 mm tolerance. Online plan adaptation was left to the discretion of the daily treating physician. The primary endpoint was defined as successful completion of > 75 % of attempted fractions. Exploratory endpoints included local control and acute grade >= 3 toxicity rates after three months. For adapted fractions the contouring, planning, quality assurance, and treatment delivery times were recorded.Results: Forty-seven of 51 SBRT fractions (92 %) were successfully gated at breath-hold by optical skin surface motion monitoring. The tumor centroid position during breath-hold varied by a mean of approximately 2 mm. Sixty-three percent of fractions were adapted online with a median total treatment time of 78.5 min. After three months no local recurrences or acute grade >= 3 toxicities were observed.Conclusions: SBRT treatment to mobile targets with surface-monitored gating on a novel O-ring gantry was prospectively validated.
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