Session Item

SGRT systems have been widely available in many departments in Europe and worldwide. This emerging technology is increasingly implemented into clinical practice across a number of techniques and irradiation-sites and demands clear and structured guidance for implementation in a wide range of treatment settings. ESTRO overcome this lack of recommendations by providing an overview of staff roles and responsibilities and common and potential errors in SGRT workflows as well as comprehensive guidelines for QA procedures and frequency. The international survey on current practice, will be also presented during this session, which will give a global status of SGRT applications, its main advantages and barriers for implementation.
SGRT has become an ultrafast (milisecs) non-ionizing powerful tool for treatment reproducibility for both inter- and intrafractional, by using continuous light emission for real time dynamic patient positioning, monitoring and gating RT. Reduction of both systematic and random errors can be also be achieved during the whole treatment and respective fractions, combining patient comfort and speed with marker- and tattooless approaches.
As phase-breathing became a standard for many treatment sites workflows, allowing for OARs sparing and internal margin reduction, SGRT plays a crucial role on time domain motion control, for highly demanding and advanced treatment techniques, such as IMRT/VMAT for SBRT.
From the perspective of precision and accuracy throughout the treatment delivery process, any treatment site could benefit from this technological development, which reveals its potential not just on free breathing but also for gated RT approaches.
Regarding the combination with frameless open face immobilization systems, SGRT may also provide safe and effective treatment localization and intrafraction monitoring for intracranial treatment sites, provided by high definition submillimetric SRS precision mode, also for non-coplanar fields.
To take advantage of SGRT, a well-structured clinical implementation is recommended and therefore, a comprehensive and site-specific workflow should be clearly defined.
Several approaches will be covered during this lecture, for a global understanding of this straightforward and trendy available technology.
In conclusion, based on the international survey, despite some weaknesses the majority of participants believe that SGRT will become standard of care.