Stereotactic prostate adaptive radiotherapy utilising kilovoltage intrafraction monitoring: the TROG 15.01 SPARK trial

Paul Keall, Doan Trang Nguyen, Ricky O'Brien, Jeremy Booth, Peter Greer, Per Poulsen, Val Gebski, Andrew Kneebone, Jarad Martin, Paul Keall, Doan Trang Nguyen, Ricky O'Brien, Jeremy Booth, Peter Greer, Per Poulsen, Val Gebski, Andrew Kneebone, Jarad Martin

Abstract

Background: This paper describes the multi-institutional prospective phase II clinical trial, SPARK: Stereotactic Prostate Adaptive Radiotherapy utilizing Kilovoltage Intrafraction Monitoring (KIM). KIM is a real-time image guided radiotherapy technology being developed and clinically pioneered for prostate cancer treatment in Australia. It has potential for widespread use for target radiotherapy treatment of cancers of the pelvis, thorax and abdomen.

Methods: In the SPARK trial we will measure the cancer targeting accuracy and patient outcomes for 48 prostate cancer patients who will be treated in five treatment sessions as opposed to the conventional 40 sessions. The reduced number of treatment sessions is enabled by the KIM's increased cancer targeting accuracy.

Discussion: Real-time imaging in radiotherapy has the potential to decrease the time taken during cancer treatment and reduce the imaging dose required. With the imaging being acquired during the treatment, and the analysis being automated, there is potential for improved throughput. The SPARK trial will be conducted under the auspices of the Trans-Tasman Radiation Oncology Group (TROG).

Trial registration: This trial was registered on ClinicalTrials.gov on 09 March 2015. The identifier is: NCT02397317.

Keywords: Kilovoltage Intrafraction Monitoring; Prostate Cancer; SPARK Trial; Stereotactic Radiotherapy.

Figures

Fig. 1
Fig. 1
The SPARK study schema
Fig. 2
Fig. 2
The accumulated patient dose distributions will be quantified via paired control by comparing the accumulated dose distribution from the dose planned (left) with that from KIM corrections (middle) to that which would have been delivered without KIM (right)
Fig. 3
Fig. 3
The cancer targeting accuracy will be quantified via paired control by comparing the targeting error that would have been present without KIM (above) to the targeting error with KIM corrections (below)

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Source: PubMed

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