Evidence map›Paper›PMID 41710668›Full record

ArticleFrontiers in oncology2026

Long-term patient experience with online MR-guided radiotherapy: adaptive versus non-adaptive workflow.

Fabian Weykamp, Charlotte Herder-Wagner, Sebastian Regnery, Jakob Liermann, Eva Meixner, Philipp Hoegen-Saßmannshausen, Laila König, Kristin Lang, C Katharina Renkamp, Carolin Rippke and 3 more

Abstract read
In one paragraph

Article in Frontiers in oncology, 2026. 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. Review
  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

13 authors.

Fabian WeykampDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Charlotte Herder-WagnerDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Sebastian RegneryDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Jakob LiermannDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Eva MeixnerDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Philipp Hoegen-SaßmannshausenDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Laila KönigDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Kristin LangDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
C Katharina RenkampDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Carolin RippkeDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Sebastian KlüterDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Jürgen DebusDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
Juliane Hörner-RieberHeidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose/objective: Magnetic resonance-linear accelerator (MR-Linac) systems enable high-precision radiotherapy through real-time MR guidance and daily online adaptive treatment planning. While online adaptation offers substantial dosimetric advantages, it extends treatment session durations on an already resource-intensive platform. This study aimed to evaluate patient-reported outcome measures (PROMs) and long-term toxicity profiles associated with MR-guided radiotherapy, with a particular focus on the impact of online adaptive workflows. Materials and methods: This subgroup analysis of an ongoing prospective observational study comprises patients treated with the MRIdian Linac at the Department of Radiation Oncology at Heidelberg University Hospital between January 2019 and May 2021. Online plan adaptation was implemented in February 2020. A custom-designed in-house questionnaire (PRO-Q) was employed to assess patient experience with MR-guided treatment. Toxicity was classified according to the Common Terminology Criteria for Adverse Events (CTCAE v. 5.0). Results: A total of 231 patients were included, comprising 130 non-adaptive and 101 adaptive treatments across 286 target volumes. Baseline patient characteristics, prior systemic therapy, and median planning target volumes (36.4 mL Conclusion: Online plan adaptation at the MR-Linac increased treatment times and was associated with less favorable short-term patient-reported outcomes, yet it was delivered safely without compromising toxicity or oncologic outcomes. These results support adaptive MR-guided radiotherapy as a feasible and technically promising approach, while highlighting the need for further studies with validated PROMs and cost-benefit analyses to define its clinical value.

Indexed as

adaptive radiotherapylocal control (LC)MR-guidedpatient-reported outcomesstereotactic body radiotherapy (SBRT)

Identifiers

PMID41710668
PMCPMC12909239

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