Evidence map›Paper›PMID 39218934›Full record

ArticleRadiation oncology (London, England)2024

Dose tracking assessment for magnetic resonance guided adaptive radiotherapy of rectal cancers.

Xin Xin, Bin Tang, Fan Wu, Jinyi Lang, Jie Li, Xianliang Wang, Min Liu, Qingxian Zhang, Xiongfei Liao, Feng Yang and 1 more

Abstract read
In one paragraph

Article in Radiation oncology (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Xin XinCollege of Nuclear Technology and Automation Engineering, Chengdu University of Technology, No.1 East 3 road ErXian bridge, Chengdu, China.
Bin TangDepartment of Radiation Oncology, Sichuan Cancer Hospital & Institute, Radiation Oncology Key Laboratory of Sichuan Province, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No.55, the 4th Section, Chengdu Renmin South Road, Chengdu, China. jackytang86@163.com.
Fan WuDepartment of Radiation Oncology, Sichuan Cancer Hospital & Institute, Radiation Oncology Key Laboratory of Sichuan Province, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No.55, the 4th Section, Chengdu Renmin South Road, Chengdu, China.
Jinyi LangDepartment of Radiation Oncology, Sichuan Cancer Hospital & Institute, Radiation Oncology Key Laboratory of Sichuan Province, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No.55, the 4th Section, Chengdu Renmin South Road, Chengdu, China.
Jie LiDepartment of Radiation Oncology, Sichuan Cancer Hospital & Institute, Radiation Oncology Key Laboratory of Sichuan Province, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No.55, the 4th Section, Chengdu Renmin South Road, Chengdu, China.
Xianliang WangDepartment of Radiation Oncology, Sichuan Cancer Hospital & Institute, Radiation Oncology Key Laboratory of Sichuan Province, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No.55, the 4th Section, Chengdu Renmin South Road, Chengdu, China.
Min LiuDepartment of Radiation Oncology, Sichuan Cancer Hospital & Institute, Radiation Oncology Key Laboratory of Sichuan Province, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No.55, the 4th Section, Chengdu Renmin South Road, Chengdu, China.
Qingxian ZhangCollege of Nuclear Technology and Automation Engineering, Chengdu University of Technology, No.1 East 3 road ErXian bridge, Chengdu, China.
Xiongfei LiaoDepartment of Radiation Oncology, Sichuan Cancer Hospital & Institute, Radiation Oncology Key Laboratory of Sichuan Province, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No.55, the 4th Section, Chengdu Renmin South Road, Chengdu, China.
Feng YangCollege of Nuclear Technology and Automation Engineering, Chengdu University of Technology, No.1 East 3 road ErXian bridge, Chengdu, China.
Lucia Clara OrlandiniDepartment of Radiation Oncology, Sichuan Cancer Hospital & Institute, Radiation Oncology Key Laboratory of Sichuan Province, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No.55, the 4th Section, Chengdu Renmin South Road, Chengdu, China.

Funding

Sichuan Cadres health and fitness research project ZH2023-801Sichuan Province Science and Technology Program 2023YFWZ0004
6 · The paper itself

Abstract

backgroundMagnetic resonance-guided adaptive radiotherapy (MRgART) at MR-Linac allows for plan optimisation on the MR-based synthetic CT (sCT) images, adjusting the target and organs at risk according to the patient's daily anatomy. Conversely, conventional linac image-guided radiotherapy (IGRT) involves rigid realignment of regions of interest to the daily anatomy, followed by the delivery of the reference computed tomography (CT) plan. This study aims to evaluate the effectiveness of MRgART versus IGRT for rectal cancer patients undergoing short-course radiotherapy, while also assessing the dose accumulation process to support the findings and determine its usefulness in enhancing treatment accuracy.

methodsNineteen rectal cancer patients treated with a 1.5 Tesla MR-Linac with a prescription dose of 25 Gy (5 Gy x 5) and undergoing daily adapted radiotherapy by plan optimization based on online MR-based sCT images, were included in this retrospective study. For each adapted plan ([Formula: see text]), a second plan ([Formula: see text]) was generated by recalculating the reference CT plan on the daily MR-based sCT images after rigid registration with the reference CT images to simulate the IGRT workflow. Dosimetry of [Formula: see text] and[Formula: see text]was compared for each fraction. Cumulative doses on the first and last fractions were evaluated for both workflows. The dosimetry per single fraction and the cumulative doses were compared using dose-volume histogram parameters.

resultsNinety-five fractions delivered with MRgART were compared to corresponding simulated IGRT fractions. All MRgART fractions fulfilled the target clinical requirements. IGRT treatments did not meet the expected target coverage for 63 out of 94 fractions (67.0%), with 13 fractions showing a V95 median point percentage decrease of 2.78% (range, 1.65-4.16%), and 55 fractions exceeding the V107% threshold with a median value of 15.4 cc (range, 6.0-43.8 cc). For the bladder, the median [Formula: see text] values were 18.18 Gy for the adaptive fractions and 19.60 Gy for the IGRT fractions. Similarly the median [Formula: see text] values for the small bowel were 23.40 Gy and 25.69 Gy, respectively. No statistically significant differences were observed in the doses accumulated on the first or last fraction for the adaptive workflow, with results consistent with the single adaptive fractions. In contrast, accumulated doses in the IGRT workflow showed significant variations mitigating the high dose constraint, nevertheless, more than half of the patients still did not meet clinical requirements.

conclusionsMRgART for short-course rectal cancer treatments ensures that the dose delivered matches each fraction of the planned dose and the results are confirmed by the dose accumulation process, which therefore seems redundant. In contrast, IGRT may lead to target dose discrepancies and non-compliance with organs at risk constraints and dose accumulation can still highlight notable dosimetric differences.

Indexed as

Magnetic Resonance ImagingOrgans at RiskRadiotherapy DosageRadiotherapy, Image-GuidedRadiotherapy Planning, Computer-AssistedRectal NeoplasmsAgedAged, 80 and overFemaleHumansMaleMiddle AgedRadiotherapy, Intensity-ModulatedRetrospective StudiesTomography, X-Ray ComputedAdaptive radiotherapyDose trackingMR-linacRectal cancer; Dose accumulationSynthetic CT

Identifiers

PMID39218934
PMCPMC11367860

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.