Stereotactic MR-guided online adaptive radiation therapy (SMART) for the treatment of liver metastases in oligometastatic patients: initial clinical experience
| Autor: | Gorkem Gungor, Meric Sengoz, Gamze Ugurluer, Banu Atalar, Ufuk Abacioglu, Gokhan Demir, Fulya Yaman Agaoglu, Teuta Zoto Mustafayev, Enis Ozyar |
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| Přispěvatelé: | Acibadem University Dspace |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Image guidance Stereotactic radiation therapy Metastases 030218 nuclear medicine & medical imaging Metastasis 03 medical and health sciences 0302 clinical medicine medicine Radiology Nuclear Medicine and imaging Oligometastatic disease Clinical Investigation medicine.diagnostic_test business.industry Soft tissue Magnetic resonance imaging Retrospective cohort study medicine.disease Radiation therapy Oncology Liver 030220 oncology & carcinogenesis Original Article Radiology business Adaptive radiation therapy MRI |
| Zdroj: | Radiation Oncology Journal |
| ISSN: | 2234-3164 2234-1900 |
| Popis: | Purpose We aimed to present our initial clinical experience on the implementation of a stereotactic MR-guided online adaptive radiation therapy (SMART) for the treatment of liver metastases in oligometastatic disease. Materials and methods Twenty-one patients (24 lesions) with liver metastasis treated with SMART were included in this retrospective study. Step-and-shoot intensity-modulated radiotherapy technique was used with daily plan adaptation. During delivery, real-time imaging was used by acquiring planar magnetic resonance images in sagittal plane for monitoring and gating. Acute and late toxicities were recorded both during treatment and follow-up visits. Results The median follow-up time was 11.6 months (range, 2.2 to 24.6 months). The median delivered total dose was 50 Gy (range, 40 to 60 Gy); with a median fraction number of 5 (range, 3 to 8 fractions) and the median fraction dose was 10 Gy (range, 7.5 to 18 Gy). Ninety-three fractions (83.7%) among 111 fractions were re-optimized. No patients were lost to follow-up and all patients were alive except one at the time of analysis. All of the patients had either complete (80.9%) or partial (19.1%) response at irradiated sites. Estimated 1-year overall survival was 93.3%. Intrahepatic and extrahepatic progression-free survival was 89.7% and 73.5% at 1 year, respectively. There was no grade 3 or higher acute or late toxicities experienced during the treatment and follow-up course. Conclusion SMART represents a new, noninvasive and effective alternative to current ablative radiotherapy methods for treatment of liver metastases in oligometastatic disease with the advantages of better visualization of soft tissue, real-time tumor tracking and potentially reduced toxicity to organs at risk. |
| Databáze: | OpenAIRE |
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