Abstract
Purpose/Objectives
Standard workflows of radiotherapy for metastatic disease palliation often involve long waiting times or multiple clinic visits. Fast palliation completed during a single clinic visit can be achieved by omitting a planning CT scan and using available diagnostic imaging for treatment planning. The use of diagnostic CT can be challenging due to differences in patient positioning and location of target and organs at risk (OAR), but adaptive treatment platforms provide possible solutions. We integrated a fast palliative workflow using diagnostic imaging for pre-planning, with subsequent on couch contour and plan adaption based on a synthetic CT derived from the cone-beam CT imaging (CBCT), and report our clinical and dosimetric experiences.
Material/methods
An ethics-approved protocol for fast palliation (FAST-METS) was implemented in November 2021. Patients referred for palliative radiotherapy of painful bony metastatic disease of any primary site, available recent diagnostic imaging (Results
Data of the first eight patients are presented. The treated metastases were located in the lumbar (2) or thoracic (3) spine and pelvis (3). In all patients, the on-couch re-optimized plan was used for treatment as clinical plan, with a PTVV95% coverage of ≥95%. In three patients, target and OAR volumes were adapted on-couch by the radiation oncologist. All patients completed their consult and treatment within 2 hours. Plan re-optimization time was Conclusion
A fast workflow for a single visit palliative IMRT delivery without dedicated planning CT scan was implemented for patients with bone metastases. All patients completed consultation and treatment within 2 hours on average, and indicated satisfaction with the procedure.
Standard workflows of radiotherapy for metastatic disease palliation often involve long waiting times or multiple clinic visits. Fast palliation completed during a single clinic visit can be achieved by omitting a planning CT scan and using available diagnostic imaging for treatment planning. The use of diagnostic CT can be challenging due to differences in patient positioning and location of target and organs at risk (OAR), but adaptive treatment platforms provide possible solutions. We integrated a fast palliative workflow using diagnostic imaging for pre-planning, with subsequent on couch contour and plan adaption based on a synthetic CT derived from the cone-beam CT imaging (CBCT), and report our clinical and dosimetric experiences.
Material/methods
An ethics-approved protocol for fast palliation (FAST-METS) was implemented in November 2021. Patients referred for palliative radiotherapy of painful bony metastatic disease of any primary site, available recent diagnostic imaging (Results
Data of the first eight patients are presented. The treated metastases were located in the lumbar (2) or thoracic (3) spine and pelvis (3). In all patients, the on-couch re-optimized plan was used for treatment as clinical plan, with a PTVV95% coverage of ≥95%. In three patients, target and OAR volumes were adapted on-couch by the radiation oncologist. All patients completed their consult and treatment within 2 hours. Plan re-optimization time was Conclusion
A fast workflow for a single visit palliative IMRT delivery without dedicated planning CT scan was implemented for patients with bone metastases. All patients completed consultation and treatment within 2 hours on average, and indicated satisfaction with the procedure.
Original language | English |
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Article number | 3337 |
Pages (from-to) | e594-e595 |
Number of pages | 2 |
Journal | International Journal of Radiation Oncology Biology Physics |
DOIs | |
Publication status | Published - 2022 |