The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumours.
Clin Transl Radiat Oncol
; 45: 100736, 2024 Mar.
Article
in En
| MEDLINE
| ID: mdl-38433949
ABSTRACT
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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Clin Transl Radiat Oncol
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: