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Journal of Cancer Research and Clinical Oncology

Published in:

30-08-2022 | Magnetic Resonance Imaging | Research

Application of real-time MRI-guided linear accelerator in stereotactic ablative body radiotherapy for non-small cell lung cancer: one step forward to precise targeting

Authors: Hye Jin Kang, Yoo-Kang Kwak, Myungsoo Kim, So Jung Lee

Published in: Journal of Cancer Research and Clinical Oncology | Issue 11/2022

Abstract

Purpose

Tumor motion is a major challenge in stereotactic ablative body radiotherapy (SABR) for non-small cell lung cancer (NSCLC), causing excessive irradiation to compensate for this motion. Real-time tumor tracking with a magnetic resonance imaging-guided linear accelerator (MR-Linac) could address this problem. This study aimed to assess the effects and advantages of MR-Linac in SABR for the treatment of lung tumors.

Methods

Overall, 41 patients with NSCLC treated with SABR using MR-Linac between March 2019 and December 2021 were included. For comparison, 40 patients treated with SABR using computed tomography-based modalities were also enrolled. The SABR dose ranged from 48 to 60 Gy in 3–5 fractions. The primary endpoint was a lower radiation volume compared to CT-based SABR. The secondary endpoint was the local control rate of SABR using the MR-Linac.

Results

The median follow-up time was 19 months (range: 3–105 months). There was no significant difference in the gross tumor volume between the MR and CT groups (7.1 ± 9.3 cm³ vs 8.0 ± 6.8 cm³, p = 0.643), but the planning target volume was significantly smaller in the MR group (20.8 ± 18.8 cm³ vs 34.1 ± 22.9 cm³, p = 0.005). The 1-year local control rates for the MR and CT groups were 92.1 and 75.4%, respectively (p = 0.07), and the 1-year overall survival rates were 87.4 and 87.0%, respectively (p = 0.30).

Conclusion

Lung SABR with MR-Linac can reduce the radiation field without compromising the local control rate. Further follow-up is needed to assess the long-term effects.

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Title: Application of real-time MRI-guided linear accelerator in stereotactic ablative body radiotherapy for non-small cell lung cancer: one step forward to precise targeting
Authors: Hye Jin Kang
Yoo-Kang Kwak
Myungsoo Kim
So Jung Lee
Publication date: 30-08-2022
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Computed Tomography
NSCLC
Computed Tomography
NSCLC
Radiotherapy
Published in: Journal of Cancer Research and Clinical Oncology / Issue 11/2022
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-022-04264-y

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Purpose

Methods

Results

Conclusion

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