The potential role of MR-guided adaptive radiotherapy in pediatric oncology: Results from a SIOPE-COG survey
Kroon, P. S.
Buatti, J. M.
Hall, M. D.
Mandeville, H. C.
Marcus, K. J.
Paulino, A. C.
Tsang, D. S.
Wolden, S. L
Janssens, G. O.
AffiliationDepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
MetadataShow full item record
AbstractBackground 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.
CitationSeravalli 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.
JournalClinical Translational Radiation Oncology
- First 500 Fractions Delivered with a Magnetic Resonance-guided Radiotherapy System: Initial Experience.
- Authors: Sahin B, Zoto Mustafayev T, Gungor G, Aydin G, Yapici B, Atalar B, Ozyar E
- Issue date: 2019 Dec 24
- Clinical implementation of magnetic resonance imaging guided adaptive radiotherapy for localized prostate cancer.
- Authors: Tetar SU, Bruynzeel AME, Lagerwaard FJ, Slotman BJ, Bohoudi O, Palacios MA
- Issue date: 2019 Jan
- Magnetic Resonance-based Response Assessment and Dose Adaptation in Human Papilloma Virus Positive Tumors of the Oropharynx treated with Radiotherapy (MR-ADAPTOR): An R-IDEAL stage 2a-2b/Bayesian phase II trial.
- Authors: Bahig H, Yuan Y, Mohamed ASR, Brock KK, Ng SP, Wang J, Ding Y, Hutcheson K, McCulloch M, Balter PA, Lai SY, Al-Mamgani A, Sonke JJ, van der Heide UA, Nutting C, Li XA, Robbins J, Awan M, Karam I, Newbold K, Harrington K, Oelfke U, Bhide S, Philippens MEP, Terhaard CHJ, McPartlin AJ, Blanchard P, Garden AS, Rosenthal DI, Gunn GB, Phan J, Cazoulat G, Aristophanous M, McSpadden KK, Garcia JA, van den Berg CAT, Raaijmakers CPJ, Kerkmeijer L, Doornaert P, Blinde S, Frank SJ, Fuller CD
- Issue date: 2018 Nov
- First prospective clinical evaluation of feasibility and patient acceptance of magnetic resonance-guided radiotherapy in Germany.
- Authors: Klüter S, Katayama S, Spindeldreier CK, Koerber SA, Major G, Alber M, Akbaba S, Debus J, Hörner-Rieber J
- Issue date: 2020 Aug
- Feasibility of Adaptive MR-guided Stereotactic Body Radiotherapy (SBRT) of Lung Tumors.
- Authors: Padgett KR, Simpson GN, Llorente R, Samuels MA, Dogan N
- Issue date: 2018 Apr 4