Stereotactic MR-Guided Radiotherapy for Adrenal Gland Metastases: First Clinical Results

Autor: Morgan Michalet, Ons Bettaïeb, Samia Khalfi, Asma Ghorbel, Simon Valdenaire, Pierre Debuire, Norbert Aillères, Roxana Draghici, Mailys De Méric De Bellefon, Marie Charissoux, Pierre Boisselier, Sylvain Demontoy, Alexis Marguerit, Morgane Cabaillé, Marie Cantaloube, Aïcha Keskes, Touria Bouhafa, Marie-Pierre Farcy-Jacquet, Pascal Fenoglietto, David Azria, Olivier Riou
Rok vydání: 2022
Předmět:
Zdroj: Journal of Clinical Medicine; Volume 12; Issue 1; Pages: 291
ISSN: 2077-0383
Popis: Stereotactic MR-guided Radiotherapy (MRgRT) is an interesting treatment option for adrenal gland metastases (AGM). We reviewed data from 12 consecutive patients treated with MRgRT for an AGM in our center between 14 November 2019 and 17 August 2021. Endpoints were tolerance assessment, the impact of adaptive treatment on target volume coverage and organs at risk (OAR) sparing, local control (LC), and overall survival (OS). The majority of patients were oligometastatic (58.3%), with 6 right AGM, 5 left AGM and 1 left and right AGM. The prescribed dose was 35 to 50 Gy in 3 to 5 fractions. The median PTV V95% on the initial plan was 95.74%. The median V95% of the PTVoptimized (PTVopt) on the initial plan was 95.26%. Thirty-eight (69%) fractions were adapted. The PTV coverage was significantly improved for adapted plans compared to predicted plans (median PTV V95% increased from 89.85% to 91.17%, p = 0.0478). The plan adaptation also significantly reduced Dmax for the stomach and small intestine. The treatment was well tolerated with no grade > 2 toxicities. With a median follow-up of 15.5 months, the 1–year LC and OS rate were 100% and 91.7%. Six patients (50%) presented a metastatic progression, and one patient (8.3%) died of metastatic evolution during the follow-up. Adaptation of the treatment plan improved the overall dosimetric quality of MRI-guided radiotherapy. A longer follow-up is required to assess late toxicities and clinical results.
Databáze: OpenAIRE