Patterns of care, tolerability and safety of the first cohort of patients treated on a novel high-field MR-Linac within the MOMENTUM Study: Initial results from a prospective Multi-Institutional Registry
Authorsvan Otterloo, S. R. M.
Christodouleas, J. P.
Blezer, E. L. A.
Erickson, B. A.
Daamen, L. A.
Fuller, C. D.
Harrington, K. J.
van der Heide, U. A.
Huddart, R. A.
Intven, M. P. W.
Kirby, A. M.
Minsky, B. D.
Nowee, M. E.
Philippens, M. E. P.
Schultz, C. J.
Tijssen, R. H. N.
Tree, A. C.
van Triest, B.
Tseng, C. L.
Hall, W. A
Verkooijen, H. M.
AffiliationDepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht, NL.
MetadataShow full item record
AbstractIntroduction: High-field MR-Linacs, linear accelerators (linac) combined with a diagnostic MRI scanner and online adaptive workflow, potentially give rise to novel online anatomic and response adaptive radiotherapy paradigms. Since the first high-field (1.5T) MR-Linac received regulatory approval in late 2018, little is known about clinical use, patient tolerability of daily high-field MRIs, and toxicity of treatments. Herein we report the initial experience within XXX (XXX), a prospective international registry of the XXX. Materials and methods: Patients were included between February 2019 to October 2020 at seven institutions in four countries. We used descriptive statistics to describe the patterns of care, tolerability (the percentage of patients discontinuing their course early) and safety (grade 3-5 CTCAE v.5 acute toxicity within 3 months after end of treatment). Results: A total 943 patients participated in the XXX Study, 702 of whom had complete baseline data at the time of this analysis. Patients were primarily male (79%) with a median age of 68 years (range: 22-93), and were treated for 39 different indications. The most frequent indications were prostate (40%), oligometastatic lymph node (17%), brain (12%), and rectal (10%) cancers. The median number of fractions was 5 (range 1-35). Six patients discontinued MR-Linac treatments, but none due to an inability to tolerate repeated high-field MRIs. Of the 415 patients with complete data on acute toxicity at 3 months follow up, eighteen (4%) patients experienced grade 3 acute toxicity related to radiation. No grade 4 or 5 acute toxicity related to radiation was observed. Conclusion: In the first 21 months of our study, patterns of care were diverse with respect to clinical utilization, body sites and radiation prescriptions. No patient discontinued treatment due to inability to tolerate daily high-field MR-scans and the acute radiation toxicity experience was encouraging.
Citationvan Otterloo SR de M, Christodouleas JP, Blezer ELA, Akhiat H, Brown K, Choudhury A, et al. Patterns of care, tolerability and safety of the first cohort of patients treated on a novel high-field MR-Linac within the MOMENTUM Study: Initial results from a prospective Multi-Institutional Registry. International Journal of Radiation Oncology*Biology*Physics. 2021 Jul.
JournalInternational Journal of Radiation Oncology Biology Physics
- The MOMENTUM Study: An International Registry for the Evidence-Based Introduction of MR-Guided Adaptive Therapy.
- Authors: de Mol van Otterloo SR, Christodouleas JP, Blezer ELA, Akhiat H, Brown K, Choudhury A, Eggert D, Erickson BA, Faivre-Finn C, Fuller CD, Goldwein J, Hafeez S, Hall E, Harrington KJ, van der Heide UA, Huddart RA, Intven MPW, Kirby AM, Lalondrelle S, McCann C, Minsky BD, Mook S, Nowee ME, Oelfke U, Orrling K, Sahgal A, Sarmiento JG, Schultz CJ, Tersteeg RJHA, Tijssen RHN, Tree AC, van Triest B, Hall WA, Verkooijen HM
- Issue date: 2020
- A daily end-to-end quality assurance workflow for MR-guided online adaptive radiation therapy on MR-Linac.
- Authors: Chen X, Ahunbay E, Paulson ES, Chen G, Li XA
- Issue date: 2020 Jan
- 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
- Initial clinical experience of Stereotactic Body Radiation Therapy (SBRT) for liver metastases, primary liver malignancy, and pancreatic cancer with 4D-MRI based online adaptation and real-time MRI monitoring using a 1.5 Tesla MR-Linac.
- Authors: Hall WA, Straza MW, Chen X, Mickevicius N, Erickson B, Schultz C, Awan M, Ahunbay E, Li XA, Paulson ES
- Issue date: 2020
- Online adaptive MR-guided stereotactic radiotherapy for unresectable malignancies in the upper abdomen using a 1.5T MR-linac.
- Authors: Daamen LA, de Mol van Otterloo SR, van Goor IWJM, Eijkelenkamp H, Erickson BA, Hall WA, Heerkens HD, Meijer GJ, Molenaar IQ, van Santvoort HC, Verkooijen HM, Intven MPW
- Issue date: 2022 Jan