A total inverse planning paradigm: Prospective clinical trial evaluating the performance of a novel MR-based 3D-printed head immobilization device.

Autor:	Jablonska PA; Department of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.; Department of Radiation Oncology, Clinica Universidad de Navarra, 31008 Pamplona, Spain., Parent A; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada., La Macchia N; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada., Chan HHL; Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, University of Toronto, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada., Filleti M; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada., Ramotar M; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada., Cho YB; Department of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.; Department of Radiation Oncology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA., Braganza M; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada., Badzynski A; Cancer Digital Intelligence Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada., Laperriere N; Department of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada., Conrad T; Department of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada., Tsang DS; Department of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada., Shultz D; Department of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada., Santiago A; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.; Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada., Irish JC; Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, University of Toronto, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.; Department of Otolaryngology - Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre/University Health Network, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada., Millar BA; Department of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada., Tadic T; Department of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.; Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, University of Toronto, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada., Berlin A; Department of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.; Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.; Guided Therapeutics (GTx) Program, Techna Institute, University Health Network, University of Toronto, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.; Cancer Digital Intelligence Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.
Jazyk:	angličtina
Zdroj:	Clinical and translational radiation oncology [Clin Transl Radiat Oncol] 2023 Jul 26; Vol. 42, pp. 100663. Date of Electronic Publication: 2023 Jul 26 (Print Publication: 2023).
DOI:	10.1016/j.ctro.2023.100663
Abstrakt:	Background and Purpose: Brain radiotherapy (cnsRT) requires reproducible positioning and immobilization, attained through redundant dedicated imaging studies and a bespoke moulding session to create a thermoplastic mask (T-mask). Innovative approaches may improve the value of care. We prospectively deployed and assessed the performance of a patient-specific 3D-printed mask (3Dp-mask), generated solely from MR imaging, to replicate a reproducible positioning and tolerable immobilization for patients undergoing cnsRT. Material and Methods: Patients undergoing LINAC-based cnsRT (primary tumors or resected metastases) were enrolled into two arms: control (T-mask) and investigational (3Dp-mask). For the latter, an in-house designed 3Dp-mask was generated from MR images to recreate the head positioning during MR acquisition and allow coupling with the LINAC tabletop. Differences in inter-fraction motion were compared between both arms. Tolerability was assessed using patient-reported questionnaires at various time points. Results: Between January 2020 - July 2022, forty patients were enrolled (20 per arm). All participants completed the prescribed cnsRT and study evaluations. Average 3Dp-mask design and printing completion time was 36 h:50 min (range 12 h:56 min - 42 h:01 min). Inter-fraction motion analyses showed three-axis displacements comparable to the acceptable tolerance for the current standard-of-care. No differences in patient-reported tolerability were seen at baseline. During the last week of cnsRT, 3Dp-mask resulted in significantly lower facial and cervical discomfort and patients subjectively reported less pressure and confinement sensation when compared to the T-mask. No adverse events were observed. Conclusion: The proposed total inverse planning paradigm using a 3D-printed immobilization device is feasible and renders comparable inter-fraction performance while offering a better patient experience, potentially improving cnsRT workflows and its cost-effectiveness. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2023 The Authors.)
Databáze:	MEDLINE
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