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

TY - JOUR

T1 - A dosimetric comparison of real-time adaptive and non-adaptive radiotherapy: A multi-institutional study encompassing robotic, gimbaled, multileaf collimator and couch tracking

AU - Colvill, Emma

AU - Booth, Jeremy

AU - Nill, Simeon

AU - Fast, Martin

AU - Bedford, James

AU - Oelfke, Uwe

AU - Nakamura, Mitsuhiro

AU - Poulsen, Per

AU - Worm, Esben

AU - Hansen, Rune

AU - Ravkilde, Thomas

AU - Scherman Rydhög, Jonas

AU - Pommer, Tobias

AU - Munck Af Rosenschold, Per

AU - Lang, Stephanie

AU - Guckenberger, Matthias

AU - Groh, Christian

AU - Herrmann, Christian

AU - Verellen, Dirk

AU - Poels, Kenneth

AU - Wang, Lei

AU - Hadsell, Michael

AU - Sothmann, Thilo

AU - Blanck, Oliver

AU - Keall, Paul

N1 - Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

PY - 2016/4

Y1 - 2016/4

N2 - 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%/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.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.

AB - 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%/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.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.

U2 - 10.1016/j.radonc.2016.03.006

DO - 10.1016/j.radonc.2016.03.006

M3 - SCORING: Journal article

C2 - 27016171

VL - 119

SP - 159

EP - 165

JO - RADIOTHER ONCOL

JF - RADIOTHER ONCOL

SN - 0167-8140

IS - 1

ER -