Evidence map›Paper›PMID 39386317›Full record

ArticleAdvances in radiation oncology2024

Magnetic Resonance Imaging Guided Radiation Therapy for Splenomegaly: Clinical Experiences and Technical Tips.

Angela Romano, Lorenzo Placidi, Luca Boldrini, Giuditta Chiloiro, Nicola Dinapoli, Matteo Galetto, Ciro Mazzarella, Guenda Meffe, Matteo Nardini, Giulia Panza and 5 more

Abstract read
In one paragraph

Article in Advances in radiation oncology, 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
  2. Article
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

15 authors.

Angela RomanoFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Lorenzo PlacidiFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Luca BoldriniFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Giuditta ChiloiroFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Nicola DinapoliFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Matteo GalettoFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Ciro MazzarellaFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Guenda MeffeFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Matteo NardiniFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Giulia PanzaFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Sara CeglieFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Patrizia ChiusoloCatholic University of Sacred Heart, Hematology Service, Rome, Italy.
Elena RossiFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Luca IndovinaFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Maria Antonietta GambacortaFondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Splenomegaly is a common manifestation in chronic lymphoid and myeloid malignancies. Although splenectomy is the preferred treatment for symptomatic splenomegaly, it carries significant risks. Radiation therapy (RT) has traditionally been considered a palliative option. This study explores the use of magnetic resonance guided radiation therapy(MRgRT) for splenic irradiation (SI) in patients with myelofibrosis (MFI) and myelodysplastic/myeloproliferative neoplasms (MDS/MPN). Methods: This single-center retrospective analysis includes patients with MFI and MDS/MPN who underwent MRgRT SI between 2018 and 2022. Ten 1 Gy fractions were delivered to the planning target volume (spleen + 3/5mm margin). An adaptive online/offline strategy has been used to reduce the dose to healthy organs. Dosimetric data and clinical outcomes, including pain relief, gastrointestinal symptoms, and hematological values, were assessed. Results: Twelve patients completed SI without interruption, with supportive transfusions as needed for cytopenias. Pain and gastrointestinal symptom relief was observed in most cases. The mean percentage reduction in spleen volume was 53.61%, with an average craniocaudal extension reduction of 77.78%. Twenty-nine (24.2%) of 120 fractions were online adapted, and 14 (11.7%) were replanned offline. Nonhematological toxicities were not reported. At a median follow-up of 12.9 months, 6 patients died, whereas 9 patients underwent hematopoietic cell transplantation, with 6 of them surviving. Conclusion: This study demonstrates MRgRT SI feasibility in MFI and MDS/MPN patients, offering symptom relief and significant spleen volume reduction. Real-time setup verification and adaptive planning allowed for tailored treatment with reduced margins, minimizing healthy tissue exposure. Larger prospective studies with longer follow-ups are needed to further validate its efficacy and safety.

Identifiers

PMID39386317
PMCPMC11459635

What OpenQuestion holds

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Registered trials

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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.