Journal Article

DKFZ-2024-01361

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Clinical Outcomes of Online Adaptive Magnetic Resonance-Guided Stereotactic Body Radiotherapy of Adrenal Metastases from a Single Institution.

Hoegen-Saßmannshausen, P. (First author)DKFZ* ; Jessen, I. ; Buchele, C. ; Schlüter, F. ; Rippke, C. ; Renkamp, C. K. ; Weykamp, F.DKFZ* ; Regnery, S. ; Liermann, J. ; Meixner, E. ; Hoeltgen, L. ; Eichkorn, T. ; König, L. ; Debus, J.DKFZ* ; Klüter, S. ; Hörner-Rieber, J. (Last author)DKFZ*

2024
MDPI Basel

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Please use a persistent id in citations: doi:10.3390/cancers16122273

Abstract: (1) Background: Recent publications foster stereotactic body radiotherapy (SBRT) in patients with adrenal oligometastases or oligoprogression. However, local control (LC) after non-adaptive SBRT shows the potential for improvement. Online adaptive MR-guided SBRT (MRgSBRT) improves tumor coverage and organ-at-risk (OAR) sparing. Long-term results of adaptive MRgSBRT are still sparse. (2) Methods: Adaptive MRgSBRT was performed on a 0.35 T MR-Linac. LC, overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and toxicity were assessed. (3) Results: 35 patients with 40 adrenal metastases were analyzed. The median gross tumor volume was 30.6 cc. The most common regimen was 10 fractions at 5 Gy. The median biologically effective dose (BED10) was 75.0 Gy. Plan adaptation was performed in 98% of all fractions. The median follow-up was 7.9 months. One local failure occurred after 16.6 months, resulting in estimated LC rates of 100% at one year and 90% at two years. ORR was 67.5%. The median OS was 22.4 months, and the median PFS was 5.1 months. No toxicity > CTCAE grade 2 occurred. (4) Conclusions: LC and ORR after adrenal adaptive MRgSBRT were excellent, even in a cohort with comparably large metastases. A BED10 of 75 Gy seems sufficient for improved LC in comparison to non-adaptive SBRT.

Keyword(s): MR-guided radiotherapy ; MR-linac ; NSCLC ; SABR ; adaptive radiotherapy ; gating ; melanoma ; oligometastasis ; oligoprogression ; online adaptation

Note: #EA:E050#LA:E050#

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Contributing Institute(s):

1. E050 KKE Strahlentherapie (E050)
2. DKTK HD zentral (HD01)

Research Program(s):

1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2024

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