The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumours
Background: The aim of this prospective observational study was to evaluate the dosimetry benefits, changes in pulmonary function, and clinical outcome of online adaptive MR-guided SBRT. Methods: From 11/2020–07/2022, 45 consecutive patients with 59 lesions underwent multi-fraction SBRT (3–8 fractio...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Clinical and Translational Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630824000132 |
| _version_ | 1797272409123848192 |
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| author | Svenja Hering Alexander Nieto Sebastian Marschner Jan Hofmaier Nina-Sophie Schmidt-Hegemann Vanessa da Silva Mendes Guillaume Landry Maximilian Niyazi Farkhad Manapov Claus Belka Stefanie Corradini Chukwuka Eze |
| author_facet | Svenja Hering Alexander Nieto Sebastian Marschner Jan Hofmaier Nina-Sophie Schmidt-Hegemann Vanessa da Silva Mendes Guillaume Landry Maximilian Niyazi Farkhad Manapov Claus Belka Stefanie Corradini Chukwuka Eze |
| author_sort | Svenja Hering |
| collection | DOAJ |
| description | Background: The aim of this prospective observational study was to evaluate the dosimetry benefits, changes in pulmonary function, and clinical outcome of online adaptive MR-guided SBRT. Methods: From 11/2020–07/2022, 45 consecutive patients with 59 lesions underwent multi-fraction SBRT (3–8 fractions) at our institution. Patients were eligible if they had biopsy-proven NSCLC or lung cancer/metastases diagnosed via clinical imaging. Endpoints were local control (LC) and overall survival (OS). We evaluated PTV/GTV dose coverage, organs at risk exposure, and changes in pulmonary function (PF). Acute toxicity was classified per the National Cancer Institute-Common Terminology Criteria for Adverse Events version 5.0. Results: The median PTV was 14.4 cm3 (range: 3.4 – 96.5 cm3). In total 195/215 (91%) plans were reoptimised. In the reoptimised vs. predicted plans, PTV coverage by the prescribed dose increased in 94.6% of all fractions with a median increase in PTV VPD of 5.6% (range: −1.8 – 44.6%, p < 0.001), increasing the number of fractions with PTV VPD ≥ 95% from 33% to 98%. The PTV D95% and D98% (BED10) increased in 93% and 95% of all fractions with a median increase of 7.7% (p < 0.001) and 10.6% (p < 0.001). The PTV D95% (BED10) increased by a mean of 9.6 Gy (SD: 10.3 Gy, p < 0.001). At a median follow-up of 21.4 months (95% CI: 12.3–27.0 months), 1- and 2-year LC rates were 94.8% (95% CI: 87.6 – 100.0%) and 91.1% (95% CI: 81.3 – 100%); 1- and 2-year OS rates were 85.6% (95% CI: 75.0 – 96.3%) and 67.1 % (95% CI: 50.3 – 83.8%). One grade ≥ 3 toxicity and no significant reduction in short-term PF parameters were recorded. Conclusions: Online adaptive MR-guided SBRT is an effective, safe and generally well tolerated treatment option for lung tumours achieving encouraging local control rates with significantly improved target volume coverage. |
| first_indexed | 2024-03-07T14:28:55Z |
| format | Article |
| id | doaj.art-468ee24657de4304ab37839934ffd84a |
| institution | Directory Open Access Journal |
| issn | 2405-6308 |
| language | English |
| last_indexed | 2024-03-07T14:28:55Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj.art-468ee24657de4304ab37839934ffd84a2024-03-06T05:27:51ZengElsevierClinical and Translational Radiation Oncology2405-63082024-03-0145100736The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumoursSvenja Hering0Alexander Nieto1Sebastian Marschner2Jan Hofmaier3Nina-Sophie Schmidt-Hegemann4Vanessa da Silva Mendes5Guillaume Landry6Maximilian Niyazi7Farkhad Manapov8Claus Belka9Stefanie Corradini10Chukwuka Eze11Department of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany; Department of Radiation Oncology, University of Tübingen, Tübingen, GermanyDepartment of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, GermanyDepartment of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany; German Cancer Consortium (DKTK), partner site Munich; and German Cancer Research Center (DKFZ), Heidelberg, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany; Bavarian Cancer Research Center (BZKF), Munich, GermanyDepartment of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, GermanyDepartment of Radiation Oncology, LMU University Hospital, LMU Munich, Munich, Germany; Corresponding author at: Department of Radiation Oncology, LMU University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.Background: The aim of this prospective observational study was to evaluate the dosimetry benefits, changes in pulmonary function, and clinical outcome of online adaptive MR-guided SBRT. Methods: From 11/2020–07/2022, 45 consecutive patients with 59 lesions underwent multi-fraction SBRT (3–8 fractions) at our institution. Patients were eligible if they had biopsy-proven NSCLC or lung cancer/metastases diagnosed via clinical imaging. Endpoints were local control (LC) and overall survival (OS). We evaluated PTV/GTV dose coverage, organs at risk exposure, and changes in pulmonary function (PF). Acute toxicity was classified per the National Cancer Institute-Common Terminology Criteria for Adverse Events version 5.0. Results: The median PTV was 14.4 cm3 (range: 3.4 – 96.5 cm3). In total 195/215 (91%) plans were reoptimised. In the reoptimised vs. predicted plans, PTV coverage by the prescribed dose increased in 94.6% of all fractions with a median increase in PTV VPD of 5.6% (range: −1.8 – 44.6%, p < 0.001), increasing the number of fractions with PTV VPD ≥ 95% from 33% to 98%. The PTV D95% and D98% (BED10) increased in 93% and 95% of all fractions with a median increase of 7.7% (p < 0.001) and 10.6% (p < 0.001). The PTV D95% (BED10) increased by a mean of 9.6 Gy (SD: 10.3 Gy, p < 0.001). At a median follow-up of 21.4 months (95% CI: 12.3–27.0 months), 1- and 2-year LC rates were 94.8% (95% CI: 87.6 – 100.0%) and 91.1% (95% CI: 81.3 – 100%); 1- and 2-year OS rates were 85.6% (95% CI: 75.0 – 96.3%) and 67.1 % (95% CI: 50.3 – 83.8%). One grade ≥ 3 toxicity and no significant reduction in short-term PF parameters were recorded. Conclusions: Online adaptive MR-guided SBRT is an effective, safe and generally well tolerated treatment option for lung tumours achieving encouraging local control rates with significantly improved target volume coverage.http://www.sciencedirect.com/science/article/pii/S2405630824000132MR-guided radiotherapyLung cancerRadiation oncologyMR-guided SBRTMR-guided SABRMR-Linac, SBRT, SABR, lung metastases |
| spellingShingle | Svenja Hering Alexander Nieto Sebastian Marschner Jan Hofmaier Nina-Sophie Schmidt-Hegemann Vanessa da Silva Mendes Guillaume Landry Maximilian Niyazi Farkhad Manapov Claus Belka Stefanie Corradini Chukwuka Eze The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumours Clinical and Translational Radiation Oncology MR-guided radiotherapy Lung cancer Radiation oncology MR-guided SBRT MR-guided SABR MR-Linac, SBRT, SABR, lung metastases |
| title | The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumours |
| title_full | The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumours |
| title_fullStr | The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumours |
| title_full_unstemmed | The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumours |
| title_short | The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumours |
| title_sort | role of online mr guided multi fraction stereotactic ablative radiotherapy in lung tumours |
| topic | MR-guided radiotherapy Lung cancer Radiation oncology MR-guided SBRT MR-guided SABR MR-Linac, SBRT, SABR, lung metastases |
| url | http://www.sciencedirect.com/science/article/pii/S2405630824000132 |
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