Treatment Time Optimization in Single Fraction Stereotactic Ablative Radiation Therapy: A 10-Year Institutional Experience

Mathieu Gaudreault; Adam Yeo; Tomas Kron; Gerard G. Hanna; Shankar Siva; Nicholas Hardcastle

doi:10.1016/j.adro.2021.100829

Treatment Time Optimization in Single Fraction Stereotactic Ablative Radiation Therapy: A 10-Year Institutional Experience

Mathieu Gaudreault^*, Adam Yeo, Tomas Kron, Gerard G. Hanna, Shankar Siva, Nicholas Hardcastle

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

12 Downloads (Pure)

Abstract

Purpose: Stereotactic ablative radiation therapy (SABR) delivered in a single fraction (SF) can be considered to have higher uncertainty given that the error probability is concentrated in a single session. This study aims to report the variation in technology and technique used and its effect on intrafraction motion based on a 10 years of experience in SF SABR.

Methods and Materials: Records of patients receiving SF SABR delivered at our instruction between 2010 and 2019 were included. Treatment parameters were extracted from the patient management database by using an in-house script. Treatment time was defined as the time difference between the first image acquisition to the last beam off of a single session. The intrafraction variation was measured from the 3-dimensional couch displacement measured after the first cone beam computed tomography (CBCT) acquired during a treatment.

Results: The number of SF SABR increased continuously from 2010 to 2019 and were mainly lung treatments. Treatment time was minimized by using volumetric modulated arc therapy, flattening filter-free dose rate, and coplanar field (24 ± 9 min). Treatment time increased as the number of CBCTs per session increased. The most common scenario involved both 2 and 3 CBCTs per session. On the average, a CBCT acquisition added 6 minutes to the treatment time. All treatments considered, the average intrafraction variation was 1.7 ± 1.6 mm.

Conclusions: SF SABR usage increased with time in our institution. The intrafraction motion was acceptable and therefore a single fraction is an efficacious treatment option when considering SABR.

Original language	English
Article number	100829
Journal	Advances in Radiation Oncology
Volume	7
Issue number	5
DOIs	https://doi.org/10.1016/j.adro.2021.100829
Publication status	Published - 16 Sept 2022
Externally published	Yes

Bibliographical note

Funding Information:
This work is funded in part by a Collaborative Research Agreement with Varian Medical Systems. This work is also funded in part by the Peter MacCallum Cancer Center Foundation. Shankar Siva is supported by the Victorian Cancer Council Colebatch Fellowship.

Funding Information:
Sources of support: This research was partially funded by Varian Medical Systems and by the Peter MacCallum Cancer Centre Foundation. Shankar Siva is supported by the Victorian Cancer Council Colebatch Fellowship.

Publisher Copyright:
© 2021 The Author(s)

ASJC Scopus subject areas

Oncology
Radiology Nuclear Medicine and imaging

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10.1016/j.adro.2021.100829Licence: CC BY-NC-ND

Treatment Time Optimization in Single Fraction Stereotactic Ablative Radiation Therapy: A 10-Year Institutional Experience
Copyright 2022 the authors. This is an open access article published under a Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits distribution and reproduction for non-commercial purposes, provided the author and source are cited.
Final published version, 702 KBLicence: CC BY-NC-ND

Cite this

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title = "Treatment Time Optimization in Single Fraction Stereotactic Ablative Radiation Therapy: A 10-Year Institutional Experience",

abstract = "Purpose: Stereotactic ablative radiation therapy (SABR) delivered in a single fraction (SF) can be considered to have higher uncertainty given that the error probability is concentrated in a single session. This study aims to report the variation in technology and technique used and its effect on intrafraction motion based on a 10 years of experience in SF SABR. Methods and Materials: Records of patients receiving SF SABR delivered at our instruction between 2010 and 2019 were included. Treatment parameters were extracted from the patient management database by using an in-house script. Treatment time was defined as the time difference between the first image acquisition to the last beam off of a single session. The intrafraction variation was measured from the 3-dimensional couch displacement measured after the first cone beam computed tomography (CBCT) acquired during a treatment. Results: The number of SF SABR increased continuously from 2010 to 2019 and were mainly lung treatments. Treatment time was minimized by using volumetric modulated arc therapy, flattening filter-free dose rate, and coplanar field (24 ± 9 min). Treatment time increased as the number of CBCTs per session increased. The most common scenario involved both 2 and 3 CBCTs per session. On the average, a CBCT acquisition added 6 minutes to the treatment time. All treatments considered, the average intrafraction variation was 1.7 ± 1.6 mm. Conclusions: SF SABR usage increased with time in our institution. The intrafraction motion was acceptable and therefore a single fraction is an efficacious treatment option when considering SABR.",

author = "Mathieu Gaudreault and Adam Yeo and Tomas Kron and Hanna, {Gerard G.} and Shankar Siva and Nicholas Hardcastle",

note = "Funding Information: This work is funded in part by a Collaborative Research Agreement with Varian Medical Systems. This work is also funded in part by the Peter MacCallum Cancer Center Foundation. Shankar Siva is supported by the Victorian Cancer Council Colebatch Fellowship. Funding Information: Sources of support: This research was partially funded by Varian Medical Systems and by the Peter MacCallum Cancer Centre Foundation. Shankar Siva is supported by the Victorian Cancer Council Colebatch Fellowship. Publisher Copyright: {\textcopyright} 2021 The Author(s)",

year = "2022",

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doi = "10.1016/j.adro.2021.100829",

language = "English",

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AU - Gaudreault, Mathieu

AU - Yeo, Adam

AU - Kron, Tomas

AU - Hanna, Gerard G.

AU - Siva, Shankar

AU - Hardcastle, Nicholas

N1 - Funding Information: This work is funded in part by a Collaborative Research Agreement with Varian Medical Systems. This work is also funded in part by the Peter MacCallum Cancer Center Foundation. Shankar Siva is supported by the Victorian Cancer Council Colebatch Fellowship. Funding Information: Sources of support: This research was partially funded by Varian Medical Systems and by the Peter MacCallum Cancer Centre Foundation. Shankar Siva is supported by the Victorian Cancer Council Colebatch Fellowship. Publisher Copyright: © 2021 The Author(s)

PY - 2022/9/16

Y1 - 2022/9/16

N2 - Purpose: Stereotactic ablative radiation therapy (SABR) delivered in a single fraction (SF) can be considered to have higher uncertainty given that the error probability is concentrated in a single session. This study aims to report the variation in technology and technique used and its effect on intrafraction motion based on a 10 years of experience in SF SABR. Methods and Materials: Records of patients receiving SF SABR delivered at our instruction between 2010 and 2019 were included. Treatment parameters were extracted from the patient management database by using an in-house script. Treatment time was defined as the time difference between the first image acquisition to the last beam off of a single session. The intrafraction variation was measured from the 3-dimensional couch displacement measured after the first cone beam computed tomography (CBCT) acquired during a treatment. Results: The number of SF SABR increased continuously from 2010 to 2019 and were mainly lung treatments. Treatment time was minimized by using volumetric modulated arc therapy, flattening filter-free dose rate, and coplanar field (24 ± 9 min). Treatment time increased as the number of CBCTs per session increased. The most common scenario involved both 2 and 3 CBCTs per session. On the average, a CBCT acquisition added 6 minutes to the treatment time. All treatments considered, the average intrafraction variation was 1.7 ± 1.6 mm. Conclusions: SF SABR usage increased with time in our institution. The intrafraction motion was acceptable and therefore a single fraction is an efficacious treatment option when considering SABR.

AB - Purpose: Stereotactic ablative radiation therapy (SABR) delivered in a single fraction (SF) can be considered to have higher uncertainty given that the error probability is concentrated in a single session. This study aims to report the variation in technology and technique used and its effect on intrafraction motion based on a 10 years of experience in SF SABR. Methods and Materials: Records of patients receiving SF SABR delivered at our instruction between 2010 and 2019 were included. Treatment parameters were extracted from the patient management database by using an in-house script. Treatment time was defined as the time difference between the first image acquisition to the last beam off of a single session. The intrafraction variation was measured from the 3-dimensional couch displacement measured after the first cone beam computed tomography (CBCT) acquired during a treatment. Results: The number of SF SABR increased continuously from 2010 to 2019 and were mainly lung treatments. Treatment time was minimized by using volumetric modulated arc therapy, flattening filter-free dose rate, and coplanar field (24 ± 9 min). Treatment time increased as the number of CBCTs per session increased. The most common scenario involved both 2 and 3 CBCTs per session. On the average, a CBCT acquisition added 6 minutes to the treatment time. All treatments considered, the average intrafraction variation was 1.7 ± 1.6 mm. Conclusions: SF SABR usage increased with time in our institution. The intrafraction motion was acceptable and therefore a single fraction is an efficacious treatment option when considering SABR.

U2 - 10.1016/j.adro.2021.100829

DO - 10.1016/j.adro.2021.100829

M3 - Article

AN - SCOPUS:85137822159

SN - 2452-1094

VL - 7

JO - Advances in Radiation Oncology

JF - Advances in Radiation Oncology

IS - 5

M1 - 100829

ER -

Treatment Time Optimization in Single Fraction Stereotactic Ablative Radiation Therapy: A 10-Year Institutional Experience

Abstract

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