Clinical Evidence Behind Prostate SBRT and The Raypilot^® System

How to optimise prostate SBRT: ESTRO clinical practice consensus recommendations

A steady rise in the number of patients receiving stereotactic body radiation therapy (SBRT) for primary prostate cancer is expected. Consequently, the current European Society for Radiotherapy and Oncology (ESTRO) ‘how to’ consensus has been developed to offer practical recommendations for the initiation and implementation of prostate SBRT in radiotherapy (RT) departments.

Why it matters: These ‘how to’ clinical practice consensus recommendations, based on the latest available evidence, are developed in cooperation with ESTRO and intended for radiation oncologists, medical physicists and RTTs to jointly implement or optimise prostate SBRT in their radiation oncology department.

ABRUPT: Toxicity and quality of life with dose-escalated SBRT using The Raypilot System

Prospective study of ablative radiotherapy for unfavourable prostate tumours with The Raypilot System, using one single fraction. Reports toxicity rates and quality-of-life outcomes at dose escalation.

Why it matters: Raypilot System-specific clinical data. Measured outcomes from patients treated with this system in routine clinical practice.

PACE-C: Moderate hypofractionation vs. SBRT, early toxicity

Head-to-head comparison of moderate hypofractionation and SBRT. Early toxicity results confirm that the increased toxicity seen with SBRT is predominantly urethra-related; the exact issue that The Raypilot System's urethra visualisation addresses. moderate hypofractionation and SBRT

Why it matters: The residual toxicity risk in SBRT is manageable with the right tools. Urethra-sparing technique is the key, and that requires knowing where the urethra is during delivery

PACE-B: Phase 3 trial of SBRT in localised prostate cancer

874 patients randomised to SBRT (5 fractions) or moderate hypofactionation or conventional fractionation (20 or 39 fractions). SBRT demonstrated non-inferiority for biochemical or clinical failure, reducing treatment from 4 weeks to 1–2 weeks with no increase in late toxicity.

Why it matters: This is the largest randomised trial confirming SBRT as a standard of care. With The Raypilot System's continuous motion tracking, margins can be tightened further, supporting the move from selected cases to routine practice.

Electromagnetic transmitter-based prostate gating for dose-escalated SBRT

Evaluates intrafraction motion magnitude and gating frequency using The Raypilot System's EM tracking. Reports the proportion of fractions where gating was triggered and the clinical impact.

Why it matters: The study shows that the Raypilot System can be easily incorporated into routine prostate LINAC-based SBRT workflows. Its use enabled the safe application of a 2 mm CTV-to-PTV margin. The study also shows that without intrafraction motion control, prostate motion would have gone undetected.

Single-Fraction Stereotactic Body Radiotherapy for Localized Prostate Cancer: A Nonrandomized Clinical Trial

Electromagnetic Transmitter-Based Prostate Gating for Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intrafraction Motionlogy

Clinical implementation of real time motion management for prostate SBRT: A radiation therapist’s perspective

Intrafraction Prostate Motion Management During Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy

Dosimetric Impact of Intrafraction Prostate Motion and Interfraction Anatomical Changes in Dose-Escalated Linac-Based SBRT

Treatment outcome and compliance to dose-intensifed linac-based SBRT for unfavorable prostate tumors using a novel real-time organ-motion tracking

Noninvasive inter- and intrafractional motion control in ultrahypofractionated radiation therapy of prostate cancer using RayPilot HypoCath™-a substitute for gold fiducial-based IGRT?