ArticleAdvances in radiation oncology2024
A Single-Institution Prospective Study To Evaluate the Safety and Efficacy of Real- Time Image-Gated Spot-Scanning Proton Therapy (RGPT) for Prostate Cancer.
Article in Advances in radiation oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 2 citations in OpenAlex.
- Clinical Comparison of Beam-Specific Planning Target Volume Single-Field Uniform Dose and Robust Intensity-Modulated Proton Therapy in Ultra-Hypofractionation for Prostate Cancer.International journal of particle therapy · 2026Article
- Fluoroscopy-Guided Motion Management in Particle Therapy: Evolution, Challenges, and AI-Enabled Opportunities.Tomography (Ann Arbor, Mich.) · 2026Review
- Modeling prompt gamma (PG) emission, detection and imaging in real patient anatomy using a novel Compton camera for dose verification in proton therapy.Physics in medicine and biology · 2025Article
- Comparison of translation algorithms in determining maximum allowable CTV shifts for Real-Time Gated Proton Therapy (RGPT) robustness evaluation in prostate cancers.Journal of applied clinical medical physics · 2025Article
- Real-Time Gated Proton Therapy: Commissioning and Clinical Workflow for the Hitachi System.International journal of particle therapy · 2024Article
Corrections and comments
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Authors and funding
15 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: In real-time image-gated spot-scanning proton therapy (RGPT), the dose distribution is distorted by gold fiducial markers placed in the prostate. Distortion can be suppressed by using small markers and more than 2 fields, but additional fields may increase the dose to organs at risk. Therefore, we conducted a prospective study to evaluate the safety and short-term clinical outcome of RGPT for prostate cancer. Methods and Materials: Based on the previously reported frequency of early adverse events (AE) and the noninferiority margin of 10%, the required number of cases was calculated to be 43 using the one-sample binomial test by the Southwest Oncology Group statistical tools with the one-sided significance level of 2.5% and the power 80%. Patients with localized prostate cancer were enrolled and 3 to 4 pure gold fiducial markers of 1.5-mm diameter were inserted in the prostate. The prescribed dose was 70 Gy(relative biologic effectiveness) in 30 fractions, and treatment was performed with 3 fields from the left, right, and the back, or 4 fields from either side of slightly anterior and posterior oblique fields. The primary endpoint was the frequency of early AE (≥grade 2) and the secondary endpoint was the biochemical relapse-free survival rate and the frequency of late AE. Results: Forty-five cases were enrolled between 2015 and 2017, and all patients completed the treatment protocol. The median follow-up period was 63.0 months. The frequency of early AE (≥grade 2) was observed in 4 cases (8.9%), therefore the noninferiority was verified. The overall 5-year biochemical relapse-free survival rate was 88.9%. As late AE, grade 2 rectal bleeding was observed in 8 cases (17.8%). Conclusions: The RGPT for prostate cancer with 1.5-mm markers and 3- or 4- fields was as safe as conventional proton therapy in early AE, and its efficacy was comparable with previous studies.
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Registered trials
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