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Online adaptive radiotherapy for head and neck cancers on the MR linear Accelerator: Introducing a novel modified Adapt-to-Shape approach
- Source :
- Clinical and Translational Radiation Oncology, Vol 32, Iss, Pp 48-51 (2022), Clinical and Translational Radiation Oncology
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Highlights • The MR-Linac provides the tools to deliver online MR-guided Adaptive Radiotherapy • Adapt-to-Shape-Lite is a novel radiotherapy planning workflow on the Elekta Unity MR-Linac • Adapt-to-Shape-Lite generated plans that fulfilled 99.9% of mandatory dose constraints • Adapt-to-Shape-Lite workflow can generate plans in relatively short durations • Therefore, we prefer Adapt-To-Shape-Lite as the primary workflow to treat Head-and-Neck cancers<br />Introduction The Elekta Unity MR-Linac (MRL) has enabled adaptive radiotherapy (ART) for patients with head and neck cancers (HNC). Adapt-To-Shape-Lite (ATS-Lite) is a novel Adapt-to-Shape strategy that provides ART without requiring daily clinician presence to perform online target and organ at risk (OAR) delineation. In this study we compared the performance of our clinically-delivered ATS-Lite strategy against three Adapt-To-Position (ATP) variants: Adapt Segments (ATP-AS), Optimise Weights (ATP-OW), and Optimise Shapes (ATP-OS). Methods Two patients with HNC received radical-dose radiotherapy on the MRL. For each fraction, an ATS-Lite plan was generated online and delivered and additional plans were generated offline for each ATP variant. To assess the clinical acceptability of a plan for every fraction, twenty clinical goals for targets and OARs were assessed for all four plans. Results 53 fractions were analysed. ATS-Lite passed 99.9% of mandatory dose constraints. ATP-AS and ATP-OW each failed 7.6% of mandatory dose constraints. The Planning Target Volumes for 54 Gy (D95% and D98%) were the most frequently failing dose constraint targets for ATP. ATS-Lite median fraction times for Patient 1 and 2 were 40 mins 9 s (range 28 mins 16 s – 47 mins 20 s) and 32 mins 14 s (range 25 mins 33 s – 44 mins 27 s), respectively. Conclusions Our early data show that the novel ATS-Lite strategy produced plans that fulfilled 99.9% of clinical dose constraints in a time frame that is tolerable for patients and comparable to ATP workflows. Therefore, ATS-Lite, which bridges the gap between ATP and full ATS, will be further utilised and developed within our institute and it is a workflow that should be considered for treating patients with HNC on the MRL.
- Subjects :
- MR-Linac
medicine.medical_specialty
business.industry
medicine.medical_treatment
Adaptive Radiotherapy
R895-920
Planning target volume
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Dose constraints
Article
MR-guided Radiotherapy
Radiation therapy
Medical physics. Medical radiology. Nuclear medicine
Time frame
Oncology
Head and Neck Neoplasms
Organ at risk
medicine
Radiology, Nuclear Medicine and imaging
Fraction (mathematics)
Radiology
Adaptive radiotherapy
business
Head and neck
RC254-282
Subjects
Details
- ISSN :
- 24056308
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Clinical and Translational Radiation Oncology
- Accession number :
- edsair.doi.dedup.....4fdaf5da94993f1cee150a02367c1e47