Evidence map›Paper›PMID 40247390›Full record

ArticleRadiation oncology (London, England)2025

Analysis of intra-fractional surface motion during adaptive radiation therapy and relation of internal vs. external position for prostate cancer.

Fernanda Macedo-Jiménez, Iris Kalisch, Anna Simeonova-Chergou, Judit Boda-Heggemann, Jens Fleckenstein, Constantin Dreher, Frank A Giordano, Florian Stieler

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Article in Radiation oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Fernanda Macedo-JiménezDepartment of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany.
Iris KalischDepartment of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany.
Anna Simeonova-ChergouDepartment of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany.
Judit Boda-HeggemannDepartment of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany.
Jens FleckensteinDepartment of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany.
Constantin DreherDepartment of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany.
Frank A GiordanoDepartment of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany.
Florian StielerDepartment of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany. Florian.Stieler@umm.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdaptive radiation therapy (ART) allows real-time treatment plan adjustment based on daily anatomical changes but involves a time-consuming workflow. Surface-guided radiation therapy (SGRT) provides precise patient positioning and intra-fractional motion management. This study retrospectively analyses intra-fractional patient motion using SGRT during long-duration radiotherapy (RT) like ART for prostate cancer and further assesses the relation for internal target position measured by cone-beam CT (CBCT) and surface position measured by SGRT.

methodsThirty ultra-hypo-fractionated prostate cancer patients (137 fractions) treated with ART on Ethos (version 1.0, Varian Medical Systems, Siemens Healthineers, Palo Alto, CA, USA) using a ring-mounted SGRT system (AlignRT inBore, Vision RT Ltd., UK) were retrospectively analyzed. The mean and standard deviation values of surface positions across three translational axes of up to 60 min of treatment were analyzed. Further, the translational shifts from the second daily CBCT before irradiation and surface position data were compared to evaluate the agreement between internal and surface position. Correlations between CBCT shifts and SGRT data were assessed with the Wilcoxon paired samples test.

resultsThe maximum mean (± SD) surface motion was - 2.21 ± 1.27 mm (vertical, at 45 min), 0.22 ± 1.55 mm (longitudinal, at 35 min), and 0.16 ± 0.77 mm (lateral, at 20 min). After the second CBCT shift, the mean (± SD) surface position deviations were - 0.63 ± 1.43 mm (vertical), -0.24 ± 1.63 mm (longitudinal), and 0.05 ± 0.87 mm (lateral) with ranges of 8.30 mm, 10.02 mm, and 6.08 mm on the vertical, longitudinal, and lateral axes, respectively. Significant differences (p < 0.05) were found between CBCT and SGRT on the vertical and longitudinal axes.

conclusionsSGRT revealed a consistent vertical shift over the whole course of long-duration RT and not only for the first minutes of the treatment. Further, SGRT exclusively is not an adequate inter-fractional positioning tool for prostate cancer patients, however additional SGRT-based intra-fractional monitoring can add a value for long duration RT.

Indexed as

Patient PositioningProstatic NeoplasmsRadiotherapy, Image-GuidedRadiotherapy, Intensity-ModulatedRadiotherapy Planning, Computer-AssistedAgedCone-Beam Computed TomographyHumansMaleRadiotherapy DosageRetrospective StudiesAdaptive radiation therapyIntra-fractional motionProstate cancerSurface-guided radiation therapy

Identifiers

PMID40247390
PMCPMC12007120

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