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Stereotactic body radiotherapy of lymph node metastases under MR-guidance: First clinical results and patient-reported outcomes

Objective Stereotactic body radiotherapy (SBRT) is a noninvasive treatment option for lymph node metastases (LNM). Magnetic resonance (MR)-guidance offers superior tissue contrast and enables treatment of targets in close vicinity to radiosensitive organs at risk (OAR). However, literature on MR-gui...

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Main Authors: Weykamp, Fabian (Author) , Herder-Wagner, Charlotte (Author) , Regnery, Sebastian (Author) , Hoegen-Saßmannshausen, Philipp (Author) , Renkamp, Claudia Katharina (Author) , Liermann, Jakob (Author) , Rippke, Carolin (Author) , Körber, Stefan A. (Author) , König, Laila (Author) , Buchele, Carolin (Author) , Klüter, Sebastian (Author) , Debus, Jürgen (Author) , Hörner-Rieber, Juliane (Author)
Format: Article (Journal)
Language:English
Published: 2022
In: Strahlentherapie und Onkologie
Year: 2022, Volume: 198, Issue: 1, Pages: 56-65
ISSN:1439-099X
DOI:10.1007/s00066-021-01834-w
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1007/s00066-021-01834-w
Verlag, kostenfrei, Volltext: https://link.springer.com/10.1007/s00066-021-01834-w
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Author Notes:Fabian Weykamp, Charlotte Herder-Wagner, Sebastian Regnery, Philipp Hoegen, C. Katharina Renkamp, Jakob Liermann, Carolin Rippke, Stefan A. Koerber, Laila König, Carolin Buchele, Sebastian Klüter, Jürgen Debus, Juliane Hörner-Rieber
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Summary:Objective Stereotactic body radiotherapy (SBRT) is a noninvasive treatment option for lymph node metastases (LNM). Magnetic resonance (MR)-guidance offers superior tissue contrast and enables treatment of targets in close vicinity to radiosensitive organs at risk (OAR). However, literature on MR-guided SBRT of LNM is scarce with no report on outcome parameters. Materials and methods We report a subgroup analysis of a prospective observational study comprising patients with LNM. Patients received MR-guided SBRT at our MRIdian Linac (ViewRay Inc., Mountain View, CA, USA) between January 2019 and February 2020. Local control (LC), progression-free survival (PFS) and overall survival (OS) analysis were performed using the Kaplan-Meier method with log rank test to test for significance (p < 0.05). Our patient-reported outcome questionnaire was utilized to evaluate patients’ perspective. The CTCAE (Common Terminology Criteria for Adverse Events) v. 5.0 was used to describe toxicity. - Results Twenty-nine patients (72.4% with prostate cancer; 51.7% with no distant metastases) received MR-guided SBRT for in total 39 LNM. Median dose was 27 Gy in three fractions, prescribed to the 80% isodose. At 1-year, estimated LC, PFS and OS were 92.6, 67.4 and 100.0%. Compared to baseline, six patients (20.7%) developed new grade I toxicities (mainly fatigue). One grade II toxicity occurred (fatigue), with no adverse event grade ≥III. Overall treatment experience was rated particularly positive, while the technically required low room temperature still represents the greatest obstacle in the pursuit of the ideal patient acceptance. - Conclusion MR-guided SBRT of LNM was demonstrated to be a well-accepted treatment modality with excellent preliminary results. Future studies should evaluate the clinical superiority to conventional SBRT.
Item Description:Online veröffentlicht: 1 September 2021
Gesehen am 21.08.2023
Physical Description:Online Resource
ISSN:1439-099X
DOI:10.1007/s00066-021-01834-w

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