ESTRO 2024 - Abstract Book

S5457

RTT - Patient care, preparation, immobilisation and IGRT verification protocols

ESTRO 2024

Purpose/Objective:

There is now good evidence to support the notion that stereotactic ablative body radiotherapy (SABR) is a safe and effective, curative-intent treatment for primary Renal Cell Carcinoma (RCC) [2] . Effective motion management is crucial in upper abdominal tumours, inclusive of kidney tumours. Careful planning and respiratory motion management (RMM), which includes both passive motion management (PMM) and active motion management (AMM), can be applied to mitigate the effects of both inter- and intra-fractional motion. This descriptive review explored both PMM and AMM, specifically in the context of renal SABR. The primary research question centres on the necessity of motion management. Secondary objectives include investigating when motion management is required and methods for enhancing control of respiratory motion (RM) for precise and stable treatment delivery. This PROSPERO-registered systematic review (CRD42023455044) followed a PRISMA approach. The search strategy was developed by the lead researcher following training from the University College London’s library services. Eligible studies were in English and published from 2003 to 2023. Due to the absence of RCC SABR studies older than 20 years, papers were limited to this timeframe. Searches were carried out on 21st August 2023 and encompassed CINAHL, MEDLINE, EMBASE, EMCARE. Two reviewers carried out all screening, with disagreements resolved by a third reviewer. Eligibility criteria, based on the PICOS process, included primary RCC studies and other studies reporting kidney motion data. Studies without RM management or assessment were excluded. Basket studies with multiple tumour sites were excluded when data from less than 3 renal cases were reported. All SABR techniques were considered, including all machine types. All RM management methods, both PMM and AMM, were considered, with the comparison group being no motion management or free breathing (FB). Data extraction covered general information, eligibility, participant details, motion management strategies, study design, methods, and accuracy data. Data was tabulated using the Template for Intervention, Description and Replication (TIDieR) checklist. RefWorks was used for reference management. Quality assurance was carried out by 2 reviewers using SIGN guidelines and uncertainties were discussed with the third reviewer. The heterogeneity and diversity in data lead to synthesis without meta-analysis (SWiM). Motion management strategies were grouped by passive or active approaches and equipment/procedures. Material/Methods:

Results: