Multi-target Tracking in Prostate Radiotherapy Using MLC and KIM (KOALA)
Prostate Cancer
About this trial
This is an interventional treatment trial for Prostate Cancer focused on measuring Prostate, Radiotherapy, IGRT, VMAT, Image-guided radiation therapy, Volumetric modulated arc therapy, Adaptive radiotherapy
Eligibility Criteria
Inclusion Criteria:
- Patients undergoing definitive external beam radiotherapy at Northern Sydney Cancer Centre
- Patients histologically proven prostate adenocarcinoma
- PSA obtained within 3 months prior to enrolment
- Pelvic lymph nodes are included for treatment for patients at stage T1c-T3b with Gleason 8-10 or prostate-specific antigen (PSA) > 20 ng/ml or pelvic lymph node positivity on conventional imaging or prostate-specific membrane antigen (PSMA) scans.
- Patient must be able to have gold fiducial markers placed in the prostate
- Eastern Cooperative Oncology Group (ECOG) performance status 0-2
- Ability to understand and the willingness to sign a written informed consent document.
- Prostate dimension that allows leaf span with tracking margin of ±8mm
Exclusion Criteria:
- Patients with artificial Hip(s), lumbar spinal surgical rods or other large metallic pelvic implants
- Patient's dimensions >40cm as measured at the level of the prostate
- Patients with overlapping implanted gold fiducials in x-ray imaging
Sites / Locations
- Royal North Shore Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Stage 1: Optimise nodal treatment margin
Stage 2: Use treatment margin
During Stage 1: Optimise nodal treatment margin, Combined real-time use of 'Multi-Leaf Collimator Adaptation' and 'kV Intrafraction Monitoring' will be used to reshape the radiation beam in real-time. The nodal target position stability will be evaluated by the cone beam computed tomography (CBCT) imaging before and after each treatment session for the first 10 patients.
During Stage 2: Use treatment margin, Combined real-time use of 'Multi-Leaf Collimator Adaptation' and 'kV Intrafraction Monitoring' will be used to reshape the radiation beam in real-time. At the same time, multi-leaf collimator (MLC) tracking will be used to reshape the radiation beam in real-time using the margin size determined in Stage 1.