ArticleClinical and translational radiation oncology2018
Magnetic Resonance-based Response Assessment and Dose Adaptation in Human Papilloma Virus Positive Tumors of the Oropharynx treated with Radiotherapy (MR-ADAPTOR): An R-IDEAL stage 2a-2b/Bayesian phase II trial.
Article in Clinical and translational radiation oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03224000 (Bayesian Phase II Trial of Magnetic Resonance Imaging Guided Radiotherapy Dose Adaptation in Human Papilloma Virus Positive Oropharyngeal Cancer), which is not on this map. Cited by 36 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Bayesian Phase II Trial of Magnetic Resonance Imaging Guided Radiotherapy Dose Adaptation in Human Papilloma Virus Positive Oropharyngeal Cancer
Who cites it
36 citing papers in PubMed, 53 citations in OpenAlex.
- A Phase 2 Exploratory Trial Evaluating Computed Tomography-Based Midtreatment Nodal Response to Select for De-escalated Chemoradiation Therapy in the Definitive Management of p16+ Oropharyngeal Cancer.International journal of radiation oncology, biology, physics · 2026Trial
- Impact of daily adaptive head and neck radiotherapy on toxicity and quality of life: results of the DARTBOARD phase II randomized trial.Journal of the National Cancer Institute · 2025Trial
- Longitudinal assessment of diffusion-weighted imaging during magnetic resonance-guided radiotherapy in head and neck cancer.Radiation oncology (London, England) · 2025Trial
- From Imaging to Impact: A Multi-Disciplinary T32 Program Framework and Initial Insights for Training in Image-Guided Cancer Therapy [Advance Publication].Advances in cancer education and quality improvement · 2025Article
- Article
- Adaptive radiotherapy for oropharyngeal cancer with daily adapt-to-shape workflow on 1.5 T MRI-linac: Preliminary outcomes and comparison with helical tomotherapy.Clinical and translational radiation oncology · 2025Article
- New Approaches in Radiotherapy.Cancers · 2025Review
- Cost-effectiveness of personalized policies for implementing organ-at-risk sparing adaptive radiation therapy in head and neck cancer.Physics and imaging in radiation oncology · 2025Article
- Optimal timing of organs-at-risk-sparing adaptive radiation therapy for head-and-neck cancer under re-planning resource constraints.Physics and imaging in radiation oncology · 2025Article
- Optimal Timing of Organs-at-Risk-Sparing Adaptive Radiation Therapy for Head- and-Neck Cancer under Re-planning Resource Constraints.medRxiv : the preprint server for health sciences · 2024Article
- The Use of MR-Guided Radiation Therapy for Head and Neck Cancer and Recommended Reporting Guidance.Seminars in radiation oncology · 2024Review
- Personalized precision radiotherapy and its evolving role for human papillomavirus-positive oropharyngeal cancer.Journal of the National Cancer Center · 2023Review
- Head and neck cancer predictive risk estimator to determine control and therapeutic outcomes of radiotherapy (HNC-PREDICTOR): development, international multi-institutional validation, and web implementation of clinic-ready model-based risk stratification for head and neck cancer.European journal of cancer (Oxford, England : 1990) · 2023Article
- Magnetic Resonance-Guided Radiation Therapy for Head and Neck Cancers.Current oncology (Toronto, Ont.) · 2022Review
- Delineation uncertainties of tumour volumes on MRI of head and neck cancer patients.Clinical and translational radiation oncology · 2022Article
- Comprehensive Quantitative Evaluation of Variability in Magnetic Resonance-Guided Delineation of Oropharyngeal Gross Tumor Volumes and High-Risk Clinical Target Volumes: An R-IDEAL Stage 0 Prospective Study.International journal of radiation oncology, biology, physics · 2022Article
- Review
- Magnetic Resonance Guided Radiotherapy for Head and Neck Cancers.Journal of clinical medicine · 2022Review
- Magnetic resonance linear accelerator technology and adaptive radiation therapy: An overview for clinicians.CA: a cancer journal for clinicians · 2022Review
- Patient positioning and immobilization procedures for hybrid MR-Linac systems.Radiation oncology (London, England) · 2021Review
Corrections and comments
- Erratum issued
Authors and funding
42 authors at 11 institutions in 5 countries.
Funding
Abstract
backgroundCurrent standard radiotherapy for oropharynx cancer (OPC) is associated with high rates of severe toxicities, shown to adversely impact patients' quality of life. Given excellent outcomes of human papilloma virus (HPV)-associated OPC and long-term survival of these typically young patients, treatment de-intensification aimed at improving survivorship while maintaining excellent disease control is now a central concern. The recent implementation of magnetic resonance image - guided radiotherapy (MRgRT) systems allows for individual tumor response assessment during treatment and offers possibility of personalized dose-reduction. In this 2-stage Bayesian phase II study, we propose to examine weekly radiotherapy dose-adaptation based on magnetic resonance imaging (MRI) evaluated tumor response. Individual patient's plan will be designed to optimize dose reduction to organs at risk and minimize locoregional failure probability based on serial MRI during RT. Our primary aim is to assess the non-inferiority of MRgRT dose adaptation for patients with low risk HPV-associated OPC compared to historical control, as measured by Bayesian posterior probability of locoregional control (LRC).
methodsPatients with T1-2 N0-2b (as per AJCC 7th Edition) HPV-positive OPC, with lymph node <3 cm and <10 pack-year smoking history planned for curative radiotherapy alone to a dose of 70 Gy in 33 fractions will be eligible. All patients will undergo pre-treatment MRI and at least weekly intra-treatment MRI. Patients undergoing MRgRT will have weekly adaptation of high dose planning target volume based on gross tumor volume response. The stage 1 of this study will enroll 15 patients to MRgRT dose adaptation. If LRC at 6 months with MRgRT dose adaptation is found sufficiently safe as per the Bayesian model, stage 2 of the protocol will expand enrollment to an additional 60 patients, randomized to either MRgRT or standard IMRT. DISCUSSION: Multiple methods for safe treatment de-escalation in patients with HPV-positive OPC are currently being studied. By leveraging the ability of advanced MRI techniques to visualize tumor and soft tissues through the course of treatment, this protocol proposes a workflow for safe personalized radiation dose-reduction in good responders with radiosensitive tumors, while ensuring tumoricidal dose to more radioresistant tumors. MRgRT dose adaptation could translate in reduced long term radiation toxicities and improved survivorship while maintaining excellent LRC outcomes in favorable OPC.
trial registrationClinicalTrials.gov ID: NCT03224000; Registration date: 07/21/2017.
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