Interruptions and uncertainties associated in real-time fiducial tracking treatment delivery of carcinoma prostate using cyberknife radiosurgery - A monoinstitutional radiation therapists study

J Cancer Res Ther. 2025 Apr 1;21(3):583-592. doi: 10.4103/jcrt.jcrt_410_24. Epub 2025 Jul 5.

Abstract

Objective: The fiducial-based CyberKnife (CK) radiosurgery system is used to track the intrafraction motion of tumor in real time to diminish the dose to the surrounding normal tissues. Radiation therapists (RTTs) are accountable for eradicating uncertainties and interruptions and for delivering precise treatment. The intent of this study is to quantify and emphasize the list of potential uncertainties and interruptions as well as to provide solutions to reduce the treatment execution time, which may lead to improved patient satisfaction.

Material and methods: This retrospective study includes 20 (n = 20) carcinoma prostate patients treated using the CK fiducial-based tracking method. Treatment uncertainties and interruptions data in the initial ten patients (P1 to P10) have been collected using case report files (CRFs). Uncertainties and interruption data were accounted and analyzed for possible solutions. Class solutions for specific error were identified and applied for further consecutive ten patients (P11 to P20). Treatment delivery execution time and patient satisfaction levels were assessed between both groups by using statistical tools and data interpretation systems.

Results: The study evidently indicates that the implemented error resolving strategies significantly reduced the treatment delivery execution time by 16% and a remarkable 18.29% increment in overall patient satisfaction level.

Conclusion: This study contributes treasurable insights on error resolving strategies; by adopting these standardized error resolving strategies, RTTs can accomplish less interrupted treatment delivery of carcinoma prostate in the CK system with minimal time and error interferences to achieve higher patient satisfaction.

Keywords: Cyberknife radiation therapist workflow; fiducial tracking; standardization of action level; uncertainties of prostate SBRT.

MeSH terms

  • Aged
  • Fiducial Markers*
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Prostatic Neoplasms* / pathology
  • Prostatic Neoplasms* / radiotherapy
  • Prostatic Neoplasms* / surgery
  • Radiosurgery* / methods
  • Radiotherapy Planning, Computer-Assisted* / methods
  • Retrospective Studies
  • Uncertainty