Magnetic resonance-guided radiotherapy (MRgRT) for patients with lung cancer
Crockett, Cathryn Chuter, Robert Cobben, D. Dubec, Michael Green, O. Hackett, S. McDonald, F. Robinson, C. Samson, P. Shiarli, A. M.
Crockett, Cathryn
Chuter, Robert
Cobben, D.
Dubec, Michael
Green, O.
Hackett, S.
McDonald, F.
Robinson, C.
Samson, P.
Shiarli, A. M.
Citations
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Abstract
Background: Magnetic resonance-guided radiotherapy (MRgRT)
offers improved soft tissue contrast, the ability to gate and track
tumours and the option of adapting treatment daily to compensate
for changing target volumes or anatomy (Sim et al., 2020). It may
help to improve the therapeutic index of radiotherapy treatment
for lung cancer thereby improving outcomes for patients, whose
outcomes generally remain poor. Its implementation and use is not
without its challenges, however.
Method: An updated literature search on PubMed in January 2021
identified relevant papers. We also received personal correspondence
from clinicians who have had experience with MRgRT in the lung
cancer setting. Treatments on the ViewRay MRIdian or the Elekta
Unity radiotherapy machines were reviewed.
Results: Several centres around the world have now treated patients
with lung cancer with MRgRT (Crockett et al., 2021). Most of the
treatments were delivered on the MRIdian and involved the use of
stereotactic ablative radiotherapy for early-stage or oligometastatic
disease, including (ultra-) central tumours. The majority of centres
adapted treatments daily based on anatomical changes. Low rates of
severe toxicity (0-8% ≥ grade 3) have been reported and preliminary
outcome data appears favourable. Technical issues relating to
MRgRT treatment in lung cancer have been highlighted, including
challenges relating to image quality, the magnetic field’s effect on
dose distribution and accounting for both physiological respiratory
and cardiac motion.
Conclusion: The use of MRgRT for patients with lung cancer is still
in its infancy. Long-term toxicity data is currently lacking. Future
studies will focus on addressing technical issues surrounding its use
and the feasibility of treating patients with stage III disease using
adaptive RT, as this group is likely where the advantages of MRgRT
may be best exploited. The first UK patient with lung cancer will be
treated on a Unity MR-linac in April 2021.
Affiliation
Description
Date
2021
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Crockett C, Chuter R, Cobben D, Dubec M, Green O, Hackett S, et al. Magnetic resonance-guided radiotherapy (MRgRT) for patients with lung cancer. Lung Cancer . 2021 Jun;156:S62.