ArticleJTO clinical and research reports2023
Magnetic Resonance-Guided Stereotactic Body Radiation Therapy/Hypofractionated Radiation therapy for Metastatic and Primary Central and Ultracentral Lung Lesions.
Article in JTO clinical and research reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Adaptive skin radiotherapy (ASRT): Clinical outcomes and dosimetric evaluation of a time-efficient approach for online adaptive MRI-guided radiotherapy in thorax.Clinical and translational radiation oncology · 2026Article
- Safety and Efficacy of Stereotactic Magnetic Resonance-Guided Adaptive Radiation Therapy (SMART) for Ultracentral Metastases in Non-Small Cell Lung Cancer.Advances 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
- Lung Stereotactic Body Radiotherapy (SBRT): Challenging Scenarios and New Frontiers.Journal of clinical medicine · 2025Review
- How to protect the proximal bronchial tree during stereotactic radiotherapy of ultracentral lung tumors: Lessons from MR-guided treatment.Clinical and translational radiation oncology · 2025Article
- Recent Advances and Current Challenges in Stereotactic Body Radiotherapy for Ultra-Central Lung Tumors.Cancers · 2024Review
- Magnetic Resonance Imaging Guided Radiation Therapy for Splenomegaly: Clinical Experiences and Technical Tips.Advances in radiation oncology · 2024Article
- Magnetic Resonance-Guided Cancer Therapy Radiomics and Machine Learning Models for Response Prediction.Tomography (Ann Arbor, Mich.) · 2024Review
- Review
- Article
- Structure-specific rigid dose accumulation dosimetric analysis of ablative stereotactic MRI-guided adaptive radiation therapy in ultracentral lung lesions.Communications medicine · 2024Article
- Accelerated Hypofractionated Magnetic Resonance Guided Adaptive Radiation Therapy for Ultracentral Lung Tumors.Tomography (Ann Arbor, Mich.) · 2024Article
- Single institution experience of MRI-guided radiotherapy for thoracic tumors and clinical characteristics impacting treatment duty cycle.Frontiers in oncology · 2024Article
- Review
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Authors and funding
13 authors.
Funding
Abstract
Introduction: The recent results from the Nordic-HILUS study indicate stereotactic body radiation therapy (SBRT) is associated with high-grade toxicity for ultracentral (UC) tumors. We hypothesized that magnetic resonance-guided SBRT (MRgSBRT) or hypofractionated radiation therapy (MRgHRT) enables the safe delivery of high-dose radiation to central and UC lung lesions. Methods: Patients with UC or central lesions were treated with MRgSBRT/MRgHRT with real-time gating or adaptation. Central lesions were defined as per the Radiation Therapy Oncology Group and UC as per the HILUS study definitions: (1) group A or tumors less than 1 cm from the trachea and/or mainstem bronchi; or (2) group B or tumors less than 1 cm from the lobar bronchi. The Kaplan-Meier estimate and log-rank test were used to estimate survival. Associations between toxicities and other patient factors were tested using the Mann-Whitney Results: A total of 47 patients were included with a median follow-up of 22.9 months (95% confidence interval: 16.4-29.4). Most (53%) had metastatic disease. All patients had central lesions and 55.3% (n = 26) had UC group A. The median distance from the proximal bronchial tree was 6.0 mm (range: 0.0-19.0 mm). The median biologically equivalent dose (α/β = 10) was 105 Gy (range: 75-151.2). The most common radiation schedule was 60 Gy in eight fractions (40.4%). Most (55%) had previous systemic therapy, 32% had immunotherapy and 23.4% had previous thoracic radiation therapy. There were 16 patients who underwent daily adaptation. The 1-year overall survival was 82% (median = not reached), local control 87% (median = not reached), and progression-free survival 54% (median = 15.1 mo, 95% confidence interval: 5.1-25.1). Acute toxicity included grade 1 (26%) and grade 2 (21%) with only two patients experiencing grade 3 (4.3%) in the long term. No grade 4 or 5 toxicities were seen. Conclusions: Previous studies noted high rates of toxicity after SBRT to central and UC lung lesions, with reports of grade 5 toxicities. In our cohort, the use of MRgSBRT/MRgHRT with high biologically effective doses was well tolerated, with two grade 3 toxicities and no grade 4/5.
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