CASE STUDY | MONTEFIORE MEDICAL CENTER
Real-time Adaptive Motion Management In Prostate Stereotactic Body Radiation Therapy (Sbrt): Clinical and Dosimetric Analysis of 25 Patients
Authors:
Published:
Methods:
| Design | Retrospective study of 25 patients with localized prostate cancer |
| Treatments | SBRT - 40 Gy in 5 fractions |
| Planning | Accuray Precision® Treatment Planning System using VOLO™ Classic or VOLO Ultra optimizer, 2.5 cm dynamic jaws |
| Motion Management | Synchrony® real-time motion management system on the Radixact® System |
| Follow-up | Median 28 months; toxicity graded by CTCAE v4.03 |
Results:
- Dosimetry: All plans met target coverage and organ at-risk (OAR) constraints; average PTV conformality index 1.13, homogeneity index 1.09.
- Motion: All but one patient had ≥1 fraction with >2 mm motion; abrupt large motions (>5 mm) occurred 77 times over 36 treatments, sometimes requiring mid-treatment CT/repositioning.
- PSA Response: Median post-treatment PSA 0.30 ng/mL; all patients <2.0 ng/mL at 15 months; transient PSA “bounces” seen in 3 patients.
- Toxicity: 14 patients had new grade 1 genitourinary (GU) symptoms; 3 had grade 2 GU toxicity; 5 had grade 1 gastrointestinal symptoms; 3 reported grade 1 gastrointestinal symptoms; 3 reported grade 1 fatigue
Conclusion:
Limitations include the retrospective design, the small sample size, and lack of patient-reported data.
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Important Safety Information:
Most side effects of radiotherapy, including radiotherapy delivered with Accuray systems, are mild and temporary, often involving fatigue, nausea, and skin irritation. Side effects can be severe, however, leading to pain, alterations in normal body functions (for example, urinary or salivary function), deterioration of quality of life, permanent injury, and even death. Side effects can occur during or shortly after radiation treatment or in the months and years following radiation. The nature and severity of side effects depend on many factors, including the size and location of the treated tumor, the treatment technique (for example, the radiation dose), and the patient’s general medical condition, to name a few. For more details about the side effects of your radiation therapy, and to see if treatment with an Accuray product is right for you, ask your doctor. Accuray Incorporated as a medical device manufacturer cannot and does not recommend specific treatment approaches. Individual results may vary.
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