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- Title
Direct Monitoring Of Intraprostatic Motion Via Intrafraction Motion Management For Prostate Hypofractionated Vmat Irradiation: First Clinical Results In Malaysia.
- Authors
Khairul, Mohd; Idalia, Nur; Suzanah, Ida
- Abstract
Background: In this study we report the first clinical results in Malaysia of monitoring the prostate movement during the VMAT delivery through the use of Intrafraction Motion Management (IMM) system (Varian Medical Systems). The software made automatic marker detection in prostate cancer patients with fiducial markers (FMs) feasible with auto beam hold should there be a discrepancy in the FMs positioning. Method: Imaging data of patients with prostatic carcinoma treated with RapidArc technique on a Truebeam STx linear accelerator were evaluated. Patients were positioned supine in customised vacuum bags and adhered stringent bowel preparation and bladder protocols. Each patient had 3 implanted gold FMs and underwent a hypofractionation regimen of 70Gy in 28 fractions. 2D kV images were automatically acquired at 8-second intervals during treatment delivery via 'triggered imaging'. The actual position of the FMs was directly compared with their expected position represented by a green circle on the acquired image. Results: Treatment time with IMM was assessed and compared to non-IMM. Retrospective analysis of the average displacement of the markers from the 2D kV images was tabulated in the superior-inferior, antero-posterior and lateral directions. Images acquired from the lateral dimension are difficult to analyze retrospectively due to overlapping of FMs. Conclusion Verification of intrafraction prostatic motion is now possible with simultaneous treatment delivery. However, continuous assessment is required should there be future plans for margin reduction or dose escalation where late rectal toxicity is at risk.
- Subjects
MALAYSIA; PROSTATE; PROSTATE cancer patients; MOTION; LINEAR accelerators; MARGINS (Futures trading)
- Publication
Journal of Cancer Research & Therapeutics, 2017, Vol 13, pS186
- ISSN
0973-1482
- Publication type
Article