ArticleTechnical innovations & patient support in radiation oncology2020
On-line adaptive MR guided radiotherapy for locally advanced pancreatic cancer: Clinical and dosimetric considerations.
Article in Technical innovations & patient support in radiation oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 1 of them a synthesis that pooled it.
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Who cites it
52 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinical application of MR-Linac in tumor radiotherapy: a systematic review.Radiation oncology (London, England) · 2023Pooled it
- Article
- Development of a cost-effective end-to-end commissioning test for simulation-omitted direct-to-unit adaptive radiotherapy.Physics and imaging in radiation oncology · 2026Article
- Evaluating the role of plan complexity metrics in online adaptive radiotherapy for pancreatic cancer patients.Medical physics · 2026Article
- Optical Flow-Guided Analysis of Intrafractional Anatomical Variations in Pancreatic Tumors and Organs at Risk During Magnetic Resonance-Guided Adaptive Radiation Therapy Under Abdominal Compression.Advances in radiation oncology · 2026Article
- Dose Prediction Deep Learning-Based Model for VMAT of Prostate Cancer Applying Magnetic Resonance Image (MRI) in Versa HD Linear Accelerator.Advanced biomedical research · 2026Article
- Improved PTV coverage and OAR sparing with stereotactic MRI-guided online adaptive radiotherapy with elective fields in pancreatic cancer.Technical innovations & patient support in radiation oncology · 2025Article
- MRI-guided stereotactic body radiation therapy for very elderly patients with primary lung cancer: a retrospective analysis of safety and efficacy profiles.La Radiologia medica · 2025Article
- New Approaches in Radiotherapy.Cancers · 2025Review
- Quantification and Dosimetric Impact of Normal Organ Motion During Adaptive Radiation Therapy Planning Using a 1.5 Tesla Magnetic Resonance-Equipped Linear Accelerator (MR-Linac).Advances in radiation oncology · 2025Article
- Article
- Pan-Canadian assessment of image guided adaptive radiation therapy and the role of the radiation therapist.Technical innovations & patient support in radiation oncology · 2025Article
- Magnetic Resonance Imaging Guided Radiation Therapy for Splenomegaly: Clinical Experiences and Technical Tips.Advances in radiation oncology · 2024Article
- MR-linac based radiation therapy in gastrointestinal cancers: a narrative review.Journal of gastrointestinal oncology · 2024Review
- MOREOVER: multiomics MR-guided radiotherapy optimization in locally advanced rectal cancer.Radiation oncology (London, England) · 2024Article
- Treatment planning for MR-guided SBRT of pancreatic tumors on a 1.5 T MR-Linac: A global consensus protocol.Clinical and translational radiation oncology · 2024Article
- Early outcomes of MR-guided SBRT for patients with recurrent pancreatic adenocarcinoma.Radiation oncology (London, England) · 2024Article
- Adaptive Radiotherapy: Next-Generation Radiotherapy.Cancers · 2024Review
- Evaluation of clinical parallel workflow in online adaptive MR-guided Radiotherapy: A detailed assessment of treatment session times.Technical innovations & patient support in radiation oncology · 2024Article
- Assessment of interfraction dose variation in pancreas SBRT using daily simulation MR images.Physical and engineering sciences in medicine · 2023Article
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8 authors.
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Abstract
introductionMagnetic Resonance-guided Radiation Therapy (MRgRT) allows online adaptations (OA) of the treatment plan to optimize daily dose distribution based on patient's anatomy, just before fraction delivery. The aim of this study is to evaluate feasibility and the dosimetric improvement of the OA workflow implemented in our institution for locally advanced pancreatic cancer (LAPC) patients, in terms of target coverage and organs at risk (OARs) sparing.
methodsWe retrospectively analysed 8 LAPC patients treated with MRgRT in combination with the OA approach, using video-assisted inspiratory breath-hold for a total of 38 fractions with a dose ranging from 30 Gy to 40 Gy in 5 fractions.Dose distribution of the baseline plan was first calculated based on daily anatomy, obtaining a "predicted" plan to assess the dosimetric improvement. If the dose distribution did not meet the constraints set in the planning phase, PTV, GTV and OARs were re-contoured within a distance of 3 cm from the PTV external edge and a new online "adaptive" plan was generated. Other clinical and planning parameters were also evaluated to assess the feasibility and the dosimetic benefit of the online adaptive workflow.
resultsOut of 38 total fractions, 26 (68.4%) were adapted online and 12 (31.6%) were delivered using the baseline plan. The use of the adaptive workflow resulted to be feasible in our clinical practice and advantageous in all the patients: mean PTV V95% increased by 10.8% (5.7-20.8) while mean CTV V98% of 12.6% (7.3-17.7). Also OARs V33 and V25 showed a positive trend avoiding unnecessary irradiation.
conclusionOA workflow improves the dosimetric benefit of MRgRT, preventing the occurrence of high-doses to OARs and increasing the safety of stereotactic treatment for LAPC, without any drawback for our daily clinical practice routine.
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