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    The potential role of MR-guided adaptive radiotherapy in pediatric oncology: Results from a SIOPE-COG survey

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    Authors
    Seravalli, E.
    Kroon, P. S.
    Buatti, J. M.
    Hall, M. D.
    Mandeville, H. C.
    Marcus, K. J.
    Onal, C.
    Ozyar, E.
    Paulino, A. C.
    Paulsen, F.
    Saunders, Daniel
    Tsang, D. S.
    Wolden, S. L
    Janssens, G. O.
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    Affiliation
    Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
    Issue Date
    2021
    
    Metadata
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    Abstract
    Background and purpose: Magnetic resonance guided radiotherapy (MRgRT) has been successfully implemented for several routine clinical applications in adult patients. The purpose of this study is to map the potential benefit of MRgRT on toxicity reduction and outcome in pediatric patients treated with curative intent for primary and metastatic sites. Materials and methods: Between May and August 2020, a survey was distributed among SIOPE- and COG-affiliated radiotherapy departments, treating at least 25 pediatrics patients annually and being (candidate) users of a MRgRT system. The survey consisted of a table with 45 rows (clinical scenarios for primary (n = 28) and metastatic (n = 17) tumors) and 7 columns (toxicity reduction, outcome improvement, PTV margin reduction, target volume daily adaptation, online re-planning, intrafraction motion compensation and on-board functional imaging) and the option to answer by 'yes/no' . Afterwards, the Dutch national radiotherapy cohort was used to estimate the percentage of pediatric treatments that may benefit from MRgRT. Results: The survey was completed by 12/17 (71% response rate) institutions meeting the survey inclusion criteria. Responders indicated an 'expected benefit' from MRgRT for toxicity/outcome in 7% (for thoracic lymphomas and abdominal rhabdomyosarcomas)/0% and 18% (for mediastinal lymph nodes, lymph nodes located in the liver/splenic hilum, and liver metastases)/0% of the considered scenarios for the primary and metastatic tumor sites, respectively, and a 'possible benefit' was estimated in 64%/46% and 47%/59% of the scenarios. When translating the survey outcome into a clinical perspective a toxicity/outcome benefit, either expected or possible, was anticipated for 55%/24% of primary sites and 62%/38% of the metastatic sites. Conclusion: Although the benefit of MRgRT in pediatric radiation oncology is estimated to be modest, the potential role for reducing toxicity and improving clinical outcomes warrants further investigation. This fits best within the context of prospective studies or registration trials.
    Citation
    Seravalli E, Kroon PS, Buatti JM, Hall MD, Mandeville HC, Marcus KJ, et al. The potential role of MR-guided adaptive radiotherapy in pediatric oncology: Results from a SIOPE-COG survey. Clinical and Translational Radiation Oncology . 2021 Jul;29:71–8.
    Journal
    Clinical Translational Radiation Oncology
    URI
    http://hdl.handle.net/10541/624231
    DOI
    10.1016/j.ctro.2021.05.008
    PubMed ID
    34159265
    Additional Links
    https://dx.doi.org/10.1016/j.ctro.2021.05.008
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ctro.2021.05.008
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