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

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Publication Date
2016-04
ICR Author
Oelfke, Uwe
Nill, Simeon
Author
Colvill, E
Booth, J
Nill, S
Fast, M
Bedford, J
Oelfke, U
Nakamura, M
Poulsen, P
Worm, E
Hansen, R
Ravkilde, T
Scherman Rydhög, J
Pommer, T
Munck Af Rosenschold, P
Lang, S
Guckenberger, M
Groh, C
Herrmann, C
Verellen, D
Poels, K
Wang, L
Hadsell, M
Sothmann, T
Blanck, O
Keall, P
Type
Journal Article
Metadata
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Abstract
<h4>Purpose</h4>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.<h4>Methods and materials</h4>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.<h4>Results</h4>For all lung traces all measurement sets show improved dose accuracy with a mean 2%/2mm γ-fail rate of 1.6% with adaptation and 15.2% without adaptation (p<0.001). For all prostate the mean 2%/2mm 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%/2mm γ-fail rate of <3% for all systems with adaptation for lung and prostate.<h4>Conclusions</h4>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.
URL
https://repository.icr.ac.uk/handle/internal/85
Open access location
http://dx.doi.org/10.1016/j.radonc.2016.03.006
Collections
  • Radiotherapy and Imaging
Licenseref URL
https://creativecommons.org/licenses/by-nc-nd/4.0
Version of record
10.1016/j.radonc.2016.03.006
Subject
Humans
Lung Neoplasms
Prostatic Neoplasms
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Movement
Robotics
Computer Systems
Male
Research team
Radiotherapy Physics Modelling
Language
eng
Date accepted
2016-03-02
License start date
2016-04
Citation
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2016, 119 (1), pp. 159 - 165

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