Real-Time Adaptive Motion Management in Prostate Stereotactic Body Radiation Therapy: Clinical and Dosimetric Analysis of 25 Patients

Prostate SBRT with real-time adaptive motion management using the Radixact Synchrony system achieves excellent target coverage while mitigating the effects of intrafraction motion. The observed PSA response supports its efficacy, and OAR dose metrics remain within acceptable limits. While real-time motion adaptation was beneficial for nearly all patients, further studies with larger cohorts and patient-reported outcomes are warranted to assess long-term toxicity and quality of life.