The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumours

Hering S, Nieto A, Marschner S, Hofmaier J, Schmidt-Hegemann NS, da Silva Mendes V, Landry G, Niyazi M, Manapov F, Belka C, Corradini S, Eze C (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Clinical and Translational Radiation Oncology Elsevier

Book Volume: 45

Article Number: 100736

DOI: 10.1016/j.ctro.2024.100736

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.

Involved external institutions

Klinikum der Universität München (LMU Klinikum) DE Germany (DE)

How to cite

APA:

Hering, S., Nieto, A., Marschner, S., Hofmaier, J., Schmidt-Hegemann, N.S., da Silva Mendes, V.,... Eze, C. (2024). The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumours. Clinical and Translational Radiation Oncology, 45. https://doi.org/10.1016/j.ctro.2024.100736

MLA:

Hering, Svenja, et al. "The role of online MR-guided multi-fraction stereotactic ablative radiotherapy in lung tumours." Clinical and Translational Radiation Oncology 45 (2024).

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