Multi-Institutional Outcomes of Stereotactic Magnetic Resonance Image Guided Adaptive Radiation Therapy With a Median Biologically Effective Dose of 100 Gy10 for Non-bone Oligometastases

Kütük, Tuğçe; Herrera, Robert; Mustafayev, Teuta Zoto; Güngör, Görkem; Uğurluer, Gamze; Atalar, Banu; Kotecha, Rupesh; Hall, Matthew D; Rubens, Muni; Mittauer, K.E.; Contreras, J.; McCulloch, James; Kalman, Noah S.; Alvarez, Diane; Romaguera, Tino; Gutiérrez, Alonso N.; Garcia, Jacklyn; Kaiser, Adeel; Mehta, Minesh P.; Özyar, Enis; Chuong, Michael D.

doi:10.1016/j.adro.2022.100978

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…These results appear to be consistent with those reported by a recent multi-institutional study performed by Kutuk et al and confirm the promising potentialities of this therapeutic approach [ 28 ]. The authors collected data from 96 patients with 108 lesions (48.1% abdominal/pelvic lymph nodes) undergoing MRgRT with a median BED α/β =10 of 100 Gy, reporting 1-year freedom from local progression (FFLP), freedom from distant progression (FFDP), and PFS and OS rates of 92.3%, 41.1%, and 39.3% e 89.6%, respectively.…”

Section: Discussionsupporting

confidence: 93%

Magnetic resonance-guided stereotactic body radiation therapy (MRgSBRT) for oligometastatic patients: a single-center experience

et al. 2023

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Purpose Stereotactic body radiotherapy is increasingly used for the treatment of oligometastatic disease. Magnetic resonance-guided stereotactic radiotherapy (MRgSBRT) offers the opportunity to perform dose escalation protocols while reducing the unnecessary irradiation of the surrounding organs at risk. The aim of this retrospective, monoinstitutional study is to evaluate the feasibility and clinical benefit (CB) of MRgSBRT in the setting of oligometastatic patients. Materials and methods Data from oligometastatic patients treated with MRgSBRT were collected. The primary objectives were to define the 12-month progression-free survival (PFS) and local progression-free survival (LPFS) and 24-month overall survival (OS) rate. The objective response rate (ORR) included complete response (CR) and partial response (PR). CB was defined as the achievement of ORR and stable disease (SD). Toxicities were also assessed according to the CTCAE version 5.0 scale. Results From February 2017 to March 2021, 59 consecutive patients with a total of 80 lesions were treated by MRgSBRT on a 0.35 T hybrid unit. CR and PR as well as SD were observed in 30 (37.5%), 7 (8.75%), and 17 (21.25%) lesions, respectively. Furthermore, CB was evaluated at a rate of 67.5% with an ORR of 46.25%. Median follow-up time was 14 months (range: 3–46 months). The 12-month LPFS and PFS rates were 70% and 23%, while 24-month OS rate was 93%. No acute toxicity was reported, whereas late pulmonary fibrosis G 1 was observed in 9 patients (15.25%). Conclusion MRgSBRT was well tolerated by patients with reported low toxicity levels and a satisfying CB. Supplementary Information The online version contains supplementary material available at 10.1007/s11547-023-01627-4.

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Section: Discussionsupporting

confidence: 93%

Magnetic resonance-guided stereotactic body radiation therapy (MRgSBRT) for oligometastatic patients: a single-center experience

et al. 2023

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“…Abdominal stereotactic adaptive radiotherapy (ART) is associated with improved dosimetric and clinical outcomes [1] , [2] . However, ART can be both a time and resource consuming process, including the need to recontour the daily anatomy [3] , [4] , [5] .…”

Section: Introductionmentioning

confidence: 99%

Patient specific contouring region of interest for abdominal stereotactic adaptive radiotherapy

Price¹,

Zachary²,

Laugeman³

et al. 2023

Physics and Imaging in Radiation Oncology

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“…Additional benefits include improvements in daily setup accuracy, the ability to reduce planning target volume (PTV) margins for some disease sites, use of continuous cine tumor motion tracking and beam gating, and application of respiratory breath-hold techniques to abrogate tumor motion. In adults, MRgRT has been applied in stereotactic ablative radiotherapy (SABR) for inoperable pancreatic carcinoma and oligometastatic lesions in the abdomen, pelvis, liver, and adrenal glands with favorable early outcomes ( 1 , 2 ).…”

Section: Introductionmentioning

confidence: 99%

Initial clinical experience with magnetic resonance-guided radiotherapy in pediatric patients: Lessons learned from a single institution with proton therapy

Hall

Mittauer²,

Herrera³

et al. 2023

Front. Oncol.

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Purpose/ObjectivesMagnetic resonance-guided radiotherapy (MRgRT) is increasingly used in a variety of adult cancers. To date, published experience regarding the use of MRgRT in pediatric patients is limited to two case reports. We report on the use of MRgRT for pediatric patients at our institution during a four-year period and describe important considerations in the selection and application of this technology in children.Materials/MethodsAll patients treated with MRgRT since inception at our institution between 4/2018 and 4/2022 were retrospectively reviewed. We also evaluated all pediatric patients treated at our institution during the same period who received either imaging or treatment using our magnetic resonance-guided linear accelerator (MR Linac). We summarize four clinical cases where MRgRT was selected for treatment in our clinic, including disease outcomes and toxicities and describe our experience using the MR Linac for imaging before and during treatment for image fusion and tumor assessments.ResultsBetween 4/2018 and 4/2022, 535 patients received MRgRT at our center, including 405 (75.7%) with stereotactic ablative radiotherapy (SABR). During this period, 347 distinct radiotherapy courses were delivered to pediatric patients, including 217 (62.5%) with proton therapy. Four pediatric patients received MRgRT. One received SABR for lung metastasis with daily adaptive replanning and a second was treated for liver metastasis using a non-adaptive workflow. Two patients received fractionated MRgRT for an ALK-rearranged non-small cell lung cancer and neuroblastoma. No Grade 2 or higher toxicities were observed or reported during MRgRT or subsequent follow-up. Twelve patients underwent MR imaging without contrast during treatment for brain tumors to assess for tumor/cystic changes. Two patients treated with other modalities underwent MR simulation for target volume delineation and organ at risk sparing due to anatomic changes during treatment or unexpected delays in obtaining diagnostic MR appointments.ConclusionsIn four pediatric patients treated with MRgRT, treatment was well tolerated with no severe acute effects. At our center, most pediatric patients are treated with proton therapy, but the cases selected for MRgRT demonstrated significant organ at risk sparing compared to alternative modalities. In particular, MRgRT may provide advantages for thoracic/abdominal/pelvic targets using gated delivery and adaptive replanning, but selected patients treated with fractionated radiotherapy may also benefit MRgRT through superior organ at risk sparing.

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Multi-Institutional Outcomes of Stereotactic Magnetic Resonance Image Guided Adaptive Radiation Therapy With a Median Biologically Effective Dose of 100 Gy10 for Non-bone Oligometastases

Cited by 5 publications

References 37 publications

Magnetic resonance-guided stereotactic body radiation therapy (MRgSBRT) for oligometastatic patients: a single-center experience

Magnetic resonance-guided stereotactic body radiation therapy (MRgSBRT) for oligometastatic patients: a single-center experience

Patient specific contouring region of interest for abdominal stereotactic adaptive radiotherapy

Initial clinical experience with magnetic resonance-guided radiotherapy in pediatric patients: Lessons learned from a single institution with proton therapy

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