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000275794 245__ $$aPulmonary magnetic resonance-guided online adaptive radiotherapy of locally advanced: the PUMA trial.
000275794 260__ $$aLondon$$bBioMed Central$$c2023
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000275794 520__ $$aPatients with locally-advanced non-small-cell lung cancer (LA-NSCLC) are often ineligible for surgery, so that definitive chemoradiotherapy (CRT) represents the treatment of choice. Nevertheless, long-term tumor control is often not achieved. Intensification of radiotherapy (RT) to improve locoregional tumor control is limited by the detrimental effect of higher radiation exposure of thoracic organs-at-risk (OAR). This narrow therapeutic ratio may be expanded by exploiting the advantages of magnetic resonance (MR) linear accelerators, mainly the online adaptation of the treatment plan to the current anatomy based on daily acquired MR images. However, MR-guidance is both labor-intensive and increases treatment times, which raises the question of its clinical feasibility to treat LA-NSCLC. Therefore, the PUMA trial was designed as a prospective, multicenter phase I trial to demonstrate the clinical feasibility of MR-guided online adaptive RT in LA-NSCLC.Thirty patients with LA-NSCLC in stage III A-C will be accrued at three German university hospitals to receive MR-guided online adaptive RT at two different MR-linac systems (MRIdian Linac®, View Ray Inc. and Elekta Unity®, Elekta AB) with concurrent chemotherapy. Conventionally fractioned RT with isotoxic dose escalation up to 70 Gy is applied. Online plan adaptation is performed once weekly or in case of major anatomical changes. Patients are followed-up by thoracic CT- and MR-imaging for 24 months after treatment. The primary endpoint is twofold: (1) successfully completed online adapted fractions, (2) on-table time. Main secondary endpoints include adaptation frequency, toxicity, local tumor control, progression-free and overall survival.PUMA aims to demonstrate the clinical feasibility of MR-guided online adaptive RT of LA-NSCLC. If successful, PUMA will be followed by a clinical phase II trial that further investigates the clinical benefits of this approach. Moreover, PUMA is part of a large multidisciplinary project to develop MR-guidance techniques.ClinicalTrials.gov: NCT05237453 .
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000275794 650_7 $$2Other$$aAdaptation
000275794 650_7 $$2Other$$aFeasibility study
000275794 650_7 $$2Other$$aGating
000275794 650_7 $$2Other$$aImage-guided Radiotherapy
000275794 650_7 $$2Other$$aLung Cancer
000275794 650_7 $$2Other$$aMR-guided Radiotherapy
000275794 650_7 $$2Other$$aMRI
000275794 650_7 $$2Other$$aNon-small-cell lung carcinoma
000275794 7001_ $$ade Colle, Chiara$$b1
000275794 7001_ $$aEze, Chukwuka$$b2
000275794 7001_ $$aCorradini, Stefanie$$b3
000275794 7001_ $$aThieke, Christian$$b4
000275794 7001_ $$0P:(DE-He78)82090937e7b88ac8ec70bbc40ad6b512$$aSedlaczek, Oliver$$b5$$udkfz
000275794 7001_ $$0P:(DE-He78)3d04c8fee58c9ab71f62ff80d06b6fec$$aSchlemmer, Heinz-Peter$$b6$$udkfz
000275794 7001_ $$aDinkel, Julien$$b7
000275794 7001_ $$aSeith, Ferdinand$$b8
000275794 7001_ $$0P:(DE-He78)bb6a7a70f976eb8df1769944bf913596$$aKopp-Schneider, Annette$$b9$$udkfz
000275794 7001_ $$0P:(DE-He78)a7fec7d808abe2d2579a48df08c0f0ad$$aGillmann, Clarissa$$b10
000275794 7001_ $$aRenkamp, C Katharina$$b11
000275794 7001_ $$aLandry, Guillaume$$b12
000275794 7001_ $$aThorwarth, Daniela$$b13
000275794 7001_ $$aZips, Daniel$$b14
000275794 7001_ $$aBelka, Claus$$b15
000275794 7001_ $$0P:(DE-He78)440a3f62ea9ea5c63375308976fc4c44$$aJäkel, Oliver$$b16$$udkfz
000275794 7001_ $$0P:(DE-He78)8714da4e45acfa36ce87c291443a9218$$aDebus, Jürgen$$b17$$udkfz
000275794 7001_ $$0P:(DE-He78)c59ff25b48c192ed3fd4ad3a4bc9b9c0$$aHörner-Rieber, Juliane$$b18$$eLast author$$udkfz
000275794 773__ $$0PERI:(DE-600)2224965-5$$a10.1186/s13014-023-02258-9$$gVol. 18, no. 1, p. 74$$n1$$p74$$tRadiation oncology$$v18$$x1748-717X$$y2023
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