Adapting outside the box: Simulation-free MR-guided stereotactic ablative radiotherapy for prostate cancer

IF 4.9 1区 医学 Q1 ONCOLOGY
Jeremiah de Leon , Urszula Jelen , Madeline Carr , David Crawford , Maddison Picton , Charles Tran , Laura McKenzie , Valery Peng , Tania Twentyman , Michael G. Jameson , Vikneswary Batumalai
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引用次数: 0

Abstract

Background and purpose

Magnetic resonance (MR)-guided radiotherapy (MRgRT) enhances treatment precision and adaptive capabilities, potentially supporting a simulation-free (sim-free) workflow. This work reports the first clinical implementation of a sim-free workflow using the MR-Linac for prostate cancer patients treated with stereotactic ablative radiotherapy (SABR).

Materials and methods

Fifteen patients who had undergone a prostate-specific membrane antigen positron emission tomography/CT (PSMA-PET/CT) scan as part of diagnostic workup were included in this work. Two reference plans were generated per patient: one using PSMA-PET/CT (sim-free plan) and the other using standard simulation CT (simCT plan). Dosimetric evaluations included comparisons between simCT, sim-free, and first fraction plans. Timing measurements were conducted to assess durations for both simCT and sim-free pre-treatment workflows.

Results

All 15 patients underwent successful treatment using a sim-free workflow. Dosimetric differences between simCT, sim-free, and first fraction plans were minor and within acceptable clinical limits, with no major violations of standardised criteria. The sim-free workflow took on average 130 min, while the simCT workflow took 103 min.

Conclusion

This work demonstrates the feasibility and benefits of sim-free MR-guided adaptive radiotherapy for prostate SABR, representing the first reported clinical experience in an ablative setting. By eliminating traditional simulation scans, this approach reduces patient burden by minimising hospital visits and enhances treatment accessibility.

打破常规:无模拟磁共振引导的前列腺癌立体定向消融放射治疗。
背景和目的:磁共振(MR)引导放疗(MRgRT)提高了治疗的精确性和适应能力,有可能支持无模拟(sim-free)工作流程。这项工作报告了首次使用 MR-Linac 对前列腺癌患者进行立体定向消融放疗(SABR)的无模拟工作流程的临床实施情况:15 名患者接受了前列腺特异性膜抗原正电子发射断层扫描/CT(PSMA-PET/CT)扫描,作为诊断工作的一部分。为每位患者生成了两个参考计划:一个使用 PSMA-PET/CT(无模拟计划),另一个使用标准模拟 CT(模拟 CT 计划)。剂量评估包括 simCT 计划、无模拟计划和第一部分计划之间的比较。时间测量用于评估模拟 CT 和无模拟治疗前工作流程的持续时间:结果:所有15名患者都成功接受了无模拟工作流程的治疗。simCT、无模拟和第一部分计划之间的剂量学差异很小,在临床可接受范围内,没有严重违反标准化标准的情况。无模拟工作流程平均耗时 130 分钟,而模拟 CT 工作流程耗时 103 分钟:这项研究证明了前列腺 SABR 在无模拟 MR 引导下进行自适应放疗的可行性和优势,这也是首次在消融环境中报道的临床经验。通过取消传统的模拟扫描,这种方法最大限度地减少了患者的就医次数,从而减轻了患者的负担,并提高了治疗的可及性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Radiotherapy and Oncology
Radiotherapy and Oncology 医学-核医学
CiteScore
10.30
自引率
10.50%
发文量
2445
审稿时长
45 days
期刊介绍: Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.
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