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Dosimetric benefit of MR-guided online adaptive radiotherapy in different tumor entities: liver, lung, abdominal lymph nodes, pancreas and prostate.
- Source :
-
Radiation oncology (London, England) [Radiat Oncol] 2022 Mar 12; Vol. 17 (1), pp. 53. Date of Electronic Publication: 2022 Mar 12. - Publication Year :
- 2022
-
Abstract
- Background: Hybrid magnetic resonance (MR)-Linac systems have recently been introduced into clinical practice. The systems allow online adaption of the treatment plan with the aim of compensating for interfractional anatomical changes. The aim of this study was to evaluate the dose volume histogram (DVH)-based dosimetric benefits of online adaptive MR-guided radiotherapy (oMRgRT) across different tumor entities and to investigate which subgroup of plans improved the most from adaption.<br />Methods: Fifty patients treated with oMRgRT for five different tumor entities (liver, lung, multiple abdominal lymph nodes, pancreas, and prostate) were included in this retrospective analysis. Various target volume (gross tumor volume GTV, clinical target volume CTV, and planning target volume PTV) and organs at risk (OAR) related DVH parameters were compared between the dose distributions before and after plan adaption.<br />Results: All subgroups clearly benefited from online plan adaption in terms of improved PTV coverage. For the liver, lung and abdominal lymph nodes cases, a consistent improvement in GTV coverage was found, while many fractions of the prostate subgroup showed acceptable CTV coverage even before plan adaption. The largest median improvements in GTV near-minimum dose (D <subscript>98%</subscript> ) were found for the liver (6.3%, p < 0.001), lung (3.9%, p < 0.001), and abdominal lymph nodes (6.8%, p < 0.001) subgroups. Regarding OAR sparing, the largest median OAR dose reduction during plan adaption was found for the pancreas subgroup (-87.0%). However, in the pancreas subgroup an optimal GTV coverage was not always achieved because sparing of OARs was prioritized.<br />Conclusion: With online plan adaptation, it was possible to achieve significant improvements in target volume coverage and OAR sparing for various tumor entities and account for interfractional anatomical changes.<br /> (© 2022. The Author(s).)
- Subjects :
- Adult
Female
Humans
Liver Neoplasms pathology
Liver Neoplasms radiotherapy
Lung Neoplasms pathology
Lung Neoplasms radiotherapy
Lymphatic Metastasis pathology
Lymphatic Metastasis radiotherapy
Male
Organs at Risk
Pancreatic Neoplasms pathology
Pancreatic Neoplasms radiotherapy
Prostatic Neoplasms pathology
Prostatic Neoplasms radiotherapy
Radiotherapy Dosage
Retrospective Studies
Magnetic Resonance Imaging
Radiotherapy, Image-Guided
Subjects
Details
- Language :
- English
- ISSN :
- 1748-717X
- Volume :
- 17
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Radiation oncology (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 35279185
- Full Text :
- https://doi.org/10.1186/s13014-022-02021-6