Clinical outcomes of stereotactic magnetic resonance image-guided adaptive radiotherapy for primary and metastatic tumors in the abdomen and pelvis.
| Autor: | Yoon SM; Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA., Luterstein E; University of California San Diego School of Medicine, San Diego, CA, USA., Chu FI; Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA., Cao M; Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA., Lamb J; Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA., Agazaryan N; Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA., Low D; Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA., Raldow A; Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA., Steinberg ML; Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA., Lee P; Department of Radiation Oncology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Cancer medicine [Cancer Med] 2021 Sep; Vol. 10 (17), pp. 5897-5906. Date of Electronic Publication: 2021 Jul 20. |
| DOI: | 10.1002/cam4.4139 |
| Abstrakt: | Purpose: Stereotactic body radiotherapy (SBRT) delivers ablative doses with excellent local control. However, implementing SBRT for abdominal and pelvic tumors has been limited by the risk for treatment-related gastrointestinal toxicity. MRI-guided radiotherapy may ameliorate these risks and increase the therapeutic ratio. We report the clinical outcomes of stereotactic MRI-guided adaptive radiotherapy (SMART) for primary and metastatic tumors in the abdomen and pelvis. Methods: From November 2014 to August 2017, the first 106 consecutive patients with 121 tumors in the abdomen and pelvis were treated with SMART at a single institution. Of the cohort, 41.5%, 15.1%, and 43.4% had primary, locally recurrent, and oligometastatic tumors, respectively. SMART was delivered using a tri-cobalt-60 gantry with on-board 0.35 Tesla MRI with respiratory breath-hold and daily adaptive re-planning when anatomically necessary. A median of 40Gy in five fractions was prescribed. The Common Terminology Criteria for Adverse Events v.4.03 was used to score treatment-related toxicities. Local control (LC), progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan-Meier method. Results: Of the 510 treatments, seventy-one (13.9%) were adapted. Fatigue, nausea, and pain were the most common acute toxicities. 0.9 and 0% of patients experienced acute grade three and four toxicities, respectively. 5.2 and 2.1% of patients experienced late grade three and four toxicities, respectively. After a median follow-up of 20.4 months, the 2-year LC rate was 74% on a per-lesion basis. Two-year LC was 96% for lesions that were treated with BED Conclusions: Favorable LC and PFS outcomes were observed with minimal morbidity for tumors in the abdomen and pelvis treated with SMART. Future prospective clinical trials to validate these findings are warranted. (© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|