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000178754 041__ $$aEnglish
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000178754 1001_ $$0P:(DE-He78)f4c0be14a7bb58948e5800ccdcbfe9bc$$aRegnery, Sebastian$$b0$$eFirst author$$udkfz
000178754 245__ $$aSMART ablation of lymphatic oligometastases in the pelvis and abdomen: Clinical and dosimetry outcomes.
000178754 260__ $$aAmsterdam [u.a.]$$bElsevier Science$$c2022
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000178754 500__ $$a#EA:E050#LA:E050# / Volume 168, March 2022, Pages 106-112
000178754 520__ $$aTo demonstrate dosimetry benefits and report clinical outcomes of stereotactic magnetic resonance (MR)-guided online adaptive radiotherapy (SMART) of abdominopelvic lymphatic oligometastases.Prospective registry data of 26 patients with 31 oligoprogressive lymphatic metastases (1 - 2 lesions) who received SMART between April 2020 and April 2021 was analyzed. Prostate cancer was the most common histology (69%). Most patients (63%) had received previous abdominopelvic radiotherapy (RT). SMART was delivered in 3 - 7 fractions based on planning target volume (PTV) location and previous dose exposures. For SMART, the baseline plan was recalculated on daily 3D MR-imaging (predicted plan), and plan adaptation was mandatory in case of planning objective violations.Plan adaptation was mostly performed due to violation of planning objectives in the predicted plan (134/140 fractions, 96%) and significantly improved plan dosimetry: 1) PTV coverage was increased (predicted: median 89%, adapted: median 95%, p < 0.001), 2) organs-at-risk (OAR) overdoses were reduced (predicted: 27/140 (19%), adapted: 1/140 (1%), p < 0.001) and 3) PTV overdoses were reduced (predicted: 21/140 (15%), adapted: 1/140 (1%), p < 0.001). After a median follow-up of 9.8 months, one patient had in-field tumor progression and twelve patients had out-field tumor progression (at 6 months: progression-free survival: 63% [46 - 88%], local control rate: 97% [90 - 100%]). Treatment was tolerated well and no grade ≥ 3 toxicity was reported.SMART improves target volume coverage and yields superior OAR protection compared to non-adaptive radiotherapy, thus representing an innovative approach to challenging cases, such as repeated radiotherapy.
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000178754 650_7 $$2Other$$aImage-Guided Radiotherapy (IGRT)
000178754 650_7 $$2Other$$aLymphatic Metastasis
000178754 650_7 $$2Other$$aMagnetic Resonance Imaging (MRI)
000178754 650_7 $$2Other$$aPelvic Neoplasms
000178754 650_7 $$2Other$$aProstate Cancer
000178754 650_7 $$2Other$$aStereotactic Body Radiotherapy (SBRT)
000178754 7001_ $$aBuchele, Carolin$$b1
000178754 7001_ $$aPiskorski, Lars$$b2
000178754 7001_ $$aWeykamp, Fabian$$b3
000178754 7001_ $$aHeld, Thomas$$b4
000178754 7001_ $$aEichkorn, Tanja$$b5
000178754 7001_ $$aRippke, Carolin$$b6
000178754 7001_ $$aKatharina Renkamp, C.$$b7
000178754 7001_ $$aKlüter, Sebastian$$b8
000178754 7001_ $$aRistau, Jonas$$b9
000178754 7001_ $$aKönig, Laila$$b10
000178754 7001_ $$0P:(DE-HGF)0$$aKoerber, Stefan A$$b11
000178754 7001_ $$0P:(DE-HGF)0$$aAdeberg, Sebastian$$b12
000178754 7001_ $$0P:(DE-He78)8714da4e45acfa36ce87c291443a9218$$aDebus, Jürgen$$b13$$udkfz
000178754 7001_ $$0P:(DE-He78)c59ff25b48c192ed3fd4ad3a4bc9b9c0$$aHörner-Rieber, Juliane$$b14$$eLast author$$udkfz
000178754 773__ $$0PERI:(DE-600)1500707-8$$a10.1016/j.radonc.2022.01.038$$gp. S0167814022000640$$p106-112$$tRadiotherapy and oncology$$v168$$x0167-8140$$y2022
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