Patterns of utilization and clinical adoption of 0.35 Tesla MR-guided radiation therapy in the United States - Understanding the transition to adaptive, ultra-hypofractionated treatments.

Autor:	Chuong MD; Miami Cancer Institute, Miami, FL, United States., Clark MA; ViewRay, Inc., Denver, CO, United States., Henke LE; Washington University, School of Medicine, St. Louis, MO, United States., Kishan AU; University of California, Los Angeles Medical Center, Los Angeles, CA, United States., Portelance L; University of Miami, Miami, FL, United States., Parikh PJ; Henry Ford Health System, Grosse Pointe Farms, MI, United States., Bassetti MF; University of Wisconsin, Madison, WI, United States., Nagar H; Weill Cornell Medicine, New York, NY, United States., Rosenberg SA; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, United States., Mehta MP; Miami Cancer Institute, Miami, FL, United States., Refaat T; Loyola University Chicago, Stritch School of Medicine, Department of Radiation Oncology, Cardinal Bernardin Cancer Center, Maywood, IL, United States., Rineer JM; Orlando Health, Orlando, FL, United States., Smith A; McGlinn Cancer Institute at Reading Hospital, Tower Health, Reading, PA, United States., Seung S; Providence Cancer Institute, Portland, OR, United States., Zaki BI; Dartmouth-Hitchcock Norris Cotton Cancer Center, Lebanon, NH, United States., Fuss M; ViewRay, Inc., Denver, CO, United States., Mak RH; Dana Farber/Brigham and Women's Cancer Center, Boston, MA, United States.
Jazyk:	angličtina
Zdroj:	Clinical and translational radiation oncology [Clin Transl Radiat Oncol] 2022 Nov 22; Vol. 38, pp. 161-168. Date of Electronic Publication: 2022 Nov 22 (Print Publication: 2023).
DOI:	10.1016/j.ctro.2022.11.013
Abstrakt:	Purpose/objective: Magnetic resonance-guided radiation therapy (MRgRT) utilization is rapidly expanding worldwide, driven by advanced capabilities including continuous intrafraction visualization, automatic triggered beam delivery, and on-table adaptive replanning (oART). Our objective was to describe patterns of 0.35Tesla(T)-MRgRT (MRIdian) utilization in the United States (US) among early adopters of this novel technology. Materials/methods: Anonymized administrative data from all US MRIdian treatment systems were extracted for patients completing treatment from 2014 to 2020. Detailed treatment information was available for all MRIdian linear accelerator (linac) systems and some cobalt systems. Results: Seventeen systems at 16 centers delivered 5736 courses and 36,389 fractions (fraction details unavailable for 1223 cobalt courses), of which 21.1% were adapted. Ultra-hypofractionation (UHfx) (1-5 fractions) was used in 70.3% of all courses. At least one adaptive fraction was used for 38.5% of courses (average 1.7 adapted fractions/course), with higher oART use in UHfx dose schedules (47.7% of courses, average 1.9 adapted fractions per course). The most commonly treated organ sites were pancreas (20.7%), liver (16.5%), prostate (12.5%), breast (11.5%), and lung (9.4%). Temporal trends show a compounded annual growth rate (CAGR) of 59.6% in treatment courses delivered, with a dramatic increase in use of UHfx to 84.9% of courses in 2020 and similar increase in use of oART to 51.0% of courses. Conclusions: This is the first comprehensive study reporting patterns of utilization among early adopters of MRIdian in the US. Intrafraction MR image-guidance, advanced motion management, and increasing adoption of adaptive radiation therapy has led to a substantial transition to ultra-hypofractionated regimens. 0.35  T -MRgRT has been predominantly used to treat abdominal and pelvic tumors with increasing use of on-table adaptive replanning, which represents a paradigm shift in radiation therapy. Competing Interests: Michael Chuong reports grants and personal fees from ViewRay; personal fees and non-financial support from Accuray and Sirtex; participates on an advisory board for ViewRay. Mary Ann Clark and Martin Fuss are employees and shareholders of ViewRay, Inc. Lauren E. Henke reports consulting fees from ViewRay, Inc. and Radialogica and grants and other from Varian Medical Systems. Amar Kishan has a grant with ASTRO-PCF, consulting fees and honoraria paid by Varian Medical Systems, Inc. and ViewRay, Inc., shareholder of ViewRay, Inc. Lorraine Portelance has a consulting contract with ViewRay, Inc.Parag J. Parikh reports stock and other ownership of Nuvaira, honoraria, speakers’ bureau from ViewRay, and research funding from ViewRay. Michael F. Bassetti has a research grant from Astra Zeneca and royalties or licenses from National Jewish Hospital (Bcl3 antibody and Spi2A antibody). Himanshu Nagar participates on advisory boards for Bristol Meyers Squibb and ViewRay, Inc. Stephen A. Rosenberg participates on ViewRay medical advisory boards, Lung Research Consortium (both non-compensated), and has research grants from ViewRay; consulting fees paid by Novocure. Minesh Mehta has consulting fees from Karyopharm, Sapience, Zap, Mevion, Xoft, Tocagen; he is on the Board of Directors of Oncoceutics and owns stock in Oncoceutics and Chimerix. Bassem I. Zaki received manuscript support from ViewRay, Inc. and is a member of the ASTRO guideline subcommittee. Tamer Refaat reports nothing to disclose. Justin Rineer reports nothing to disclose. Adam Smith reports nothing to disclose. Steven Seung reports nothing to disclose. Bassem I. Zaki reports leadership role on ASTRO’s Guidelines Committee. Raymond H. Mak reports grants from ViewRay; consulting fees from ViewRay and Astra Zeneca. (© 2022 The Author(s).)
Databáze:	MEDLINE
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