Bringing online adaptive radiotherapy to a standard C-arm linac

• Published in: Physics and imaging in radiation oncology 2024-07, Vol.31, p.100597, Article 100597
• Main Authors: Groot Koerkamp, Maureen L., Bol, Gijsbert H., Kroon, Petra S., Krikke, Lean L., Harderwijk, Tessa, Zoetelief, Annelies J., Scheeren, Annick, van der Vegt, Stefan, Plat, Annika, Hes, Jochem, van Gasteren, Ineke B.A., Renders, Esmee R.T., Rutgers, Reijer H.A., Kok, Saskia W., van Kaam, Joost, Schimmel-de Kogel, Geja J., Sikkes, Gonda G., Winkel, Dennis, van Rijssel, Michael J., Wopereis, André J.M., Ishakoglu, Kübra, Noteboom, Juus L., van der Voort van Zyp, Jochem R.N., Beck, Naomi, Soeterik, Timo F.W., van de Pol, Sandrine M.G., Eppinga, Wietse S.C., van Es, Corine A., Raaymakers, Bas W.
• Format: Article
• Language: English
• Subjects: Bladder cancer; Cone-beam computed tomography; Image-guided radiotherapy; Linear accelerator; Online adaptive radiotherapy (oART)
• ISSN: 2405-6316; 2405-6316
• DOI: 10.1016/j.phro.2024.100597

•We developed an online adaptive radiotherapy (oART) workflow.•The oART workflow is cone-beam computed tomography-guided.•The oART workflow can be performed on a standard C-arm linac.•The first patients with bladder cancer were successfully treated with the workflow. Current online adaptive radiotherapy (oART) workflows require dedicated equipment. Our aim was to develop and implement an oART workflow for a C-arm linac which can be performed using standard clinically available tools. A workflow was successfully developed and implemented. Three patients receiving palliative radiotherapy for bladder cancer were treated, with 33 of 35 total fractions being delivered with the cone-beam computed tomography (CBCT)-guided oART workflow. Average oART fraction duration was 24 min from start of CBCT acquisition to end of beam on. This work shows how oART could be performed without dedicated equipment, broadening oART availability for application at existing treatment machines.