Clinical outcomes of stereotactic magnetic resonance image‐guided adaptive radiotherapy for primary and metastatic tumors in the abdomen and pelvis

Yoon, Sangpil; Luterstein, Elaine; Chu, Fang; Cao, Minsong; Lamb, James; Agazaryan, Nzhde; Low, Daniel A.; Raldow, A.; Steinberg, Michael L.; Lee, Percy

doi:10.1002/cam4.4139

Cited by 23 publications

(11 citation statements)

References 53 publications

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“…The study found that adaptive frequency was reduced, accounting for just 14% of all treatment sessions. Additionally, the study indicated positive outcomes in terms of local control and progression-free survival, with limited occurrence of toxicities [ 65 ].…”

Section: Clinical Results Of Artmentioning

confidence: 99%

Adaptive Radiotherapy: Next-Generation Radiotherapy

Dona Lemus,

Cao,

Cai

et al. 2024

Cancers

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Radiotherapy, a crucial technique in cancer therapy, has traditionally relied on the premise of largely unchanging patient anatomy during the treatment course and encompassing uncertainties by target margins. This review introduces adaptive radiotherapy (ART), a notable innovation that addresses anatomy changes and optimizes the therapeutic ratio. ART utilizes advanced imaging techniques such as CT, MRI, and PET to modify the treatment plan based on observed anatomical changes and even biological changes during the course of treatment. The narrative review provides a comprehensive guide on ART for healthcare professionals and trainees in radiation oncology and anyone else interested in the topic. The incorporation of artificial intelligence in ART has played a crucial role in improving effectiveness, particularly in contour segmentation, treatment planning, and quality assurance. This has expedited the process to render online ART feasible, lowered the burden for radiation oncology practitioners, and enhanced the precision of dynamically personalized treatment. Current technical and clinical progress on ART is discussed in this review, highlighting the ongoing development of imaging technologies and AI and emphasizing their contribution to enhancing the applicability and effectiveness of ART.

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Section: Clinical Results Of Artmentioning

confidence: 99%

Adaptive Radiotherapy: Next-Generation Radiotherapy

Dona Lemus,

Cao,

Cai

et al. 2024

Cancers

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“…retrospectively analyzed SBRT of Primary and metastatic tumors and reported a local control after 1 year of 87% an after 2 years 71%. In case of lesions treated with BED >=100 a local control after 2 years of 96% was shown ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

Local control and patient reported outcomes after online MR guided stereotactic body radiotherapy of liver metastases

et al. 2023

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IntroductionStereotactic body radiotherapy (SBRT) is used to treat liver metastases with the intention of ablation. High local control rates were shown. Magnetic resonance imaging guided radiotherapy (MRgRT) provides the opportunity of a marker-less liver SBRT treatment due to the high soft tissue contrast. We report herein on one of the largest cohorts of patients treated with online MRgRT of liver metastases focusing on oncological outcome, toxicity, patient reported outcome measures (PROMs), quality of life.Material and methodsPatients treated for liver metastases with online MR-guided SBRT at a 1,5 T MR-Linac (Unity, Elekta, Crawley, UK) between March 2019 and December 2021 were included in this prospective study. UK SABR guidelines were used for organs at risk constraints. Oncological endpoints such as survival parameters (overall survival, progression-free survival) and local control as well as patient reported acceptance and quality of life data (EORTC QLQ-C30 questionnaire) were assessed. For toxicity scoring the Common Toxicity Criteria Version 5 were used.ResultsA total of 51 patients with 74 metastases were treated with a median of five fractions. The median applied BED GTV D98 was 84,1 Gy. Median follow-up was 15 months. Local control of the irradiated liver metastasis after 12 months was 89,6%, local control of the liver was 40,3%. Overall survival (OS) after 12 months was 85.1%. Progression free survival (PFS) after 12 months was 22,4%. Local control of the irradiated liver lesion was 100% after three years when a BED ≥100 Gy was reached. The number of treated lesions did not impact local control neither of the treated or of the hepatic control. Patient acceptance of online MRgSBRT was high. There were no acute grade ≥ 3 toxicities. Quality of life data showed no significant difference comparing baseline and follow-up data.ConclusionOnline MR guided radiotherapy is a noninvasive, well-tolerated and effective treatment for liver metastases. Further prospective trials with the goal to define patients who actually benefit most from an online adaptive workflow are currently ongoing.

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“…MRI-Linac experience has shown that the addition of MRI-guidance has enabled safe dose escalation in abdominal cancers with excellent early clinical outcomes [11,61]. The ability of MRI-guided adaptive radiotherapy to improve tumour coverage or avoid a normal organ overdose that would have occurred due to anatomical variation has also been shown in abdominal SABR for primary or oligometastatic abdominal cancers [56,62]. Henke et al showed that MRI-guidance for primary or oligometastatic abdominal cancers was able to achieve dose escalation in 20%, improve tumour coverage in 65%, and reverse a normal organ overdose in 75% of fractions.…”

Section: Mri-guided Proton Therapy For Improving Dose-escalationmentioning

confidence: 99%

Magnetic resonance imaging (MRI) guided proton therapy: A review of the clinical challenges, potential benefits and pathway to implementation

Pham

Whelan

Oborn

et al. 2022

Radiotherapy and Oncology

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Clinical outcomes of stereotactic magnetic resonance image‐guided adaptive radiotherapy for primary and metastatic tumors in the abdomen and pelvis

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 23 publications

References 53 publications

Adaptive Radiotherapy: Next-Generation Radiotherapy

Adaptive Radiotherapy: Next-Generation Radiotherapy

Local control and patient reported outcomes after online MR guided stereotactic body radiotherapy of liver metastases

Magnetic resonance imaging (MRI) guided proton therapy: A review of the clinical challenges, potential benefits and pathway to implementation

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