The challenges
With rising cancer incidence and the resulting increased patient load, the East Slovakia Institute of Oncology needed to perform stereotactic radiotherapy to enable highly precise treatment in a few fractions, thereby increasing departmental efficiency. The hospital also recognized the global trend toward ultra-hypofractionation. The adoption of these efficient regimens became even more critical during the COVID-19 pandemic, as the hospital had to navigate significant capacity constraints and restricted access to care.
Given the challenges, the East Slovakia Institute of Oncology had three main objectives.
Introduce cranial and spine SRS and gradually transition to ultra-hypofractionated prostate SBRT
Perform tattooless workflows and shorten the CT planning and patient setup time
Achieve higher precision and reproducibility of patient positioning
Improve motion management during beam delivery
Substantially reduce the integral absorbed dose related to imaging due to the switch from CBCT to x-ray imaging²
The outcome*
The end result was more precision and less time all while maintaining the same number of personnel and working hours.³
Total annual fractions also held steady while patients treated increased. The team was also able to expand their treatment offering into more complex indications like cranial, spine and prostate without additional resources.
Typical treatment times per fraction in minutes
ExacTrac Dynamic has transformed our prostate cancer program, establishing ultra-hypofractionation as standard for most patients referred for primary radiotherapy. This resulted in an almost five-fold increase in prostate SBRT patients within one year (2020 vs. 2021), followed by continued gradual growth in subsequent years, while maintaining exceptional precision and efficiency.¹
The standout indication was prostate SBRT, which currently represents two thirds of all annual primary prostate radiotherapy cases. Between 2020 and 2024, the center saw a nearly six-fold increase in throughput, rising from 41 to 239 patients—each treated in only five fractions.
ExacTrac Dynamic was thus essential in enabling the transition to ultra-hypofractionation and considerably reducing the number of annual prostate treatment sessions.
The statements made by the clinician represent their personal opinion and experience. These statements may not be supported by scientific evidence or peer-reviewed research. For verified information about the device, please refer to the manufacturer's official documentation.
Cheng et al., Evaluation of Imaging Dose From Different Image Guided Systems During Head and Neck Radiotherapy: A Phantom Study, Radiation Protection Dosimetry, Volume 175, Issue 3, July 2017, Pages 357–362, https://doi.org/10.1093/rpd/ncw357
Dubinský P. et al. (2023). The Impact of Brainlab Technology Implementation on the Department Performance. Brainlab Novalis Circle 9th International Conference. https://www.novaliscircle.org/page/one-conference-2023; Dubinský, P. (2025). Hypofractionation and prostate SBRT - clinical evidence and the role of IGRT. Novalis Circle. https://www.novaliscircle.org/page/view-video?id=529