Target coverage and dose criteria based evaluation of the first clinical 1.5T MR-linac SBRT treatments of lymph node oligometastases compared with conventional CBCT-linac treatment

被引：43
作者：
Winkel, Dennis [1 ]
Bol, Gijsbert H. [1 ]
Werensteijn-Honingh, Anita M. [1 ]
Intven, Martijn P. W. [1 ]
Eppinga, Wietse S. C. [1 ]
Hes, Jochem [1 ]
Snoeren, Louk M. W. [1 ]
Sikkes, Gonda G. [1 ]
Gadellaa-van Hooijdonk, Christa G. M. [1 ]
Raaymakers, Bas W. [1 ]
Jurgenliemk-Schulz, Ina M. [1 ]
Kroon, Petra S. [1 ]
机构：
[1] Univ Med Ctr, Dept Radiotherapy, Utrecht, Netherlands
来源：
RADIOTHERAPY AND ONCOLOGY | 2020年 / 146卷
关键词：
STEREOTACTIC BODY RADIOTHERAPY; BEAM COMPUTED-TOMOGRAPHY; RADIATION-THERAPY; ADAPTIVE RADIOTHERAPY; GUIDED RADIOTHERAPY; SINGLE-ISOCENTER; PROSTATE; CANCER; DISEASE;
D O I：
10.1016/j.radonc.2020.02.011
中图分类号：
R73 [肿瘤学];
学科分类号：
100214 ;
摘要：
Background and purpose: Patients were treated at our institute for single and multiple lymph node oligometastases on the 1.5T MR-linac since August 2018. The superior soft-tissue contrast and additional software features of the MR-linac compared to CBCT-linacs allow for online adaptive treatment planning. The purpose of this study was to perform a target coverage and dose criteria based evaluation of the clinically delivered online adaptive radiotherapy treatment compared with conventional CBCT-linac treatment. Materials and methods: Patient data was used from 14 patients with single lymph node oligometastases and 6 patients with multiple (2–3) metastases. All patients were treated on the 1.5T MR-linac with a prescribed dose of 5 × 7 Gy to 95% of the PTV and a CBCT-linac plan was created for each patient. The difference in target coverage between these plans was compared and plans were evaluated based on dose criteria for each fraction after calculating the CBCT-plan on the daily anatomy. The GTV coverage was evaluated based on the online planning and the post-delivery MRI. Results: For both single and multiple lymph node oligometastases the GTV V35Gy had a median value of 100% for both the MR-linac plans and CBCT-plans pre- and post-delivery and did not significantly differ. The percentage of plans that met all dose constraints was improved from 19% to 84% and 20% to 67% for single and multiple lymph node cases, respectively. Conclusion: Target coverage and dose criteria based evaluation of the first clinical 1.5T MR-linac SBRT treatments of lymph node oligometastases compared with conventional CBCT-linac treatment shows a smaller amount of unplanned violations of high dose criteria. The GTV coverage was comparable. Benefit is primarily gained in patients treated for multiple lymph node oligometastases: geometrical deformations are accounted for, dose can be delivered in one plan and margins can be reduced. © 2020 The Authors
引用
收藏
页码：118 / 125
页数：8
相关论文
共 38 条
[1]   Inter-fraction movements of the prostate and pelvic lymph nodes during IGRT [J].
Bjoreland, Ulrika ;
Jonsson, Joakim ;
Alm, Magnus ;
Beckman, Lars ;
Nyholm, Tufve ;
Thellenberg-Karlsson, Camilla .
JOURNAL OF RADIATION ONCOLOGY, 2018, 7 (04) :357-366
[2]   Benefits of Using Stereotactic Body Radiotherapy in Patients With Metachronous Oligometastases of Hormone-Sensitive Prostate Cancer Detected by [18F]fluoromethylcholine PET/CT [J].
Bouman-Wammes, Esther W. ;
van Dodewaard-De Jong, Joyce M. ;
Dahele, Max ;
Cysouw, Matthijs C. F. ;
Hoekstra, Otto S. ;
van Moorselaar, R. Jeroen A. ;
Piet, Maartje A. H. ;
Verberne, Hein J. ;
Bins, Adriaan D. ;
Verheul, Henk M. W. ;
Slotman, Ben J. ;
Oprea-Lager, Daniela E. ;
Van den Eertwegh, Alfons J. M. .
CLINICAL GENITOURINARY CANCER, 2017, 15 (05) :E773-E782
[3]   A statistical model for analyzing the rotational error of single isocenter for multiple targets technique [J].
Chang, Jenghwa .
MEDICAL PHYSICS, 2017, 44 (06) :2115-2123
[4]   Independent Interfraction Motion of Regional Lymph Nodes and Breast Targets in Image-guided Radiotherapy of Breast Cancer [J].
Chen, G. ;
Wang, K. ;
Li, X. .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2009, 75 (03) :S208-S208
[5]   Radiotherapy as metastasis-directed therapy for oligometastatic prostate cancer [J].
De Bleser, Elise ;
Tran, Phuoc T. ;
Ost, Piet .
CURRENT OPINION IN UROLOGY, 2017, 27 (06) :587-595
[6]   Clinical feasibility study for the use of implanted gold seeds in the prostate as reliable positioning markers during megavoltage irradiation [J].
Dehnad, H ;
Nederveen, AJ ;
van der Heide, UA ;
van Moorselaar, RJA ;
Hofman, P ;
Lagendijk, JJW .
RADIOTHERAPY AND ONCOLOGY, 2003, 67 (03) :295-302
[7]   Stereotactic radiotherapy for isolated nodal recurrence of prostate cancer [J].
Detti, B. ;
Bonomo, P. ;
Masi, L. ;
Doro, R. ;
Cipressi, S. ;
Iermano, C. ;
Bonucci, I. ;
Franceschini, D. ;
Di Brina, L. ;
Bakhi, M. ;
Simontacchi, G. ;
Meattini, I. ;
Livi, L. .
WORLD JOURNAL OF UROLOGY, 2015, 33 (08) :1197-1203
[8]   Is α/β for prostate tumors really low? [J].
Fowler, J ;
Chappell, R ;
Ritter, M .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2001, 50 (04) :1021-1031
[9]  
Heerkens HD, 2017, PHYS IMAG RADIAT ONC, V2, P7, DOI 10.1016/j.phro.2017.02.003
[10]   Phase I trial of stereotactic MR-guided online adaptive radiation therapy (SMART) for the treatment of oligometastatic or unresectable primary malignancies of the abdomen [J].
Henke, Lauren ;
Kashani, Rojano ;
Robinson, Clifford ;
Curcuru, Austen ;
DeWees, Todd ;
Bradley, Jeffrey ;
Green, Olga ;
Michalski, Jeff ;
Mutic, Sasa ;
Parikh, Parag ;
Olsen, Jeffrey .
RADIOTHERAPY AND ONCOLOGY, 2018, 126 (03) :519-526
1234