Stereotactic ablative radiation for pancreatic cancer on a 1.5 Telsa magnetic resonance-linac system.
Stereotactic ablative radiation for pancreatic cancer on a 1.5 Telsa magnetic resonance-linac system.
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DOI：
10.1016/j.phro.2022.10.003
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发表时间：
2022-10
影响因子：
--
通讯作者：
Crane, Christopher H.
中科院分区：
文献类型：
--
作者：
Tringale, Kathryn R.;Tyagi, Neelam;Reyngold, Marsha;Romesser, Paul B.;Wu, Abraham;O'Reilly, Eileen M.;Varghese, Anna M.;Scripes, Paola Godoy;Khalil, Danny N.;Park, Wungki;Yu, Kenneth;Crane, Christopher H.
消融性放射治疗(A-RT)对局部晚期胰腺癌有效。30例患者接受A-RT，采用诊断性高质量MR-适应性治疗。1年内局部和远处进展的累积发生率分别为19.3%和47.4%，A-RT后1年无进展生存率分别为80.0%和39.7%。大多数局部失败在肿瘤-危险器官(OAR)交界处是边缘的。没有观察到3级或更高的毒性，尽管相邻的敏感桨。消融性放射治疗(A-RT)似乎改善了局部晚期胰腺癌(LAPC)的预后，但需要解决呼吸和消化运动的问题。我们报告了使用1.5T磁共振适应性治疗交付的胰腺癌的A-RT的结果。在2020年3月至2021年7月期间，我们使用一种新颖的压缩带工作流程和Unity 1.5T MR直线加速器系统上的远程规划，对30例胰腺癌患者进行了分5次50GyGy5次(生物有效剂量[BED10]=1100 Gy10)的治疗。进展的累积发生率是从A-RT开始计算的，死亡是一个竞争风险。采用Kaplan Meier方法计算总生存率(OS)和无进展生存率(PFS)。在30例患者中，大多数(73%)为局部晚期，4例(13%)为转移，2例(7%)为内科无法手术，2例(7%)为局部复发。大多数(73%)在A-RT之前接受了FOLFIRINOX。中位随访期分别为17.6个月(IQR15.8~23.1)和11.5个月(IQR9.7~16.1)。1年内局部进展和远处进展的累积发生率分别为19.3%(95%可信区间6.7~36.8%)和47.4%(95%可信区间26.7~65.6%)。未达到诊断和A-RT的中位数OS。诊断和A-RT的1年OS分别为96.4%(95%CI 77.2~99.5%)和80.0%(95%CI 57.3~91.4%)。中位和1年PFS分别为10.1个月(95%可信区间4.4~14.4)和39.7%(95%可信区间20.3~58.5%)。未观察到3级以上毒性反应。使用1.5T Unity MR Linac的A-RT在LAPC患者中导致了有希望的LC和OS，没有严重的毒性，尽管放射敏感的器官毗邻目标体积。需要更长的随访时间来评估长期结果。
Ablative radiation therapy (A-RT) is effective for locally advanced pancreas cancer. 30 patients received A-RT using diagnostic quality MR-adaptive treatment delivery. Cumulative incidences of 1-year local and distant progression were 19.3% and 47.4% Overall and progression-free survival 1-year from A-RT was 80.0% and 39.7% 50 Gray in 5 fractions led to promising 1-year local control and survival. Most local failures were marginal at the tumor-organ-at-risk (OAR) interface. No grade 3 or higher toxicities were observed despite adjacent sensitive OARs. Ablative radiation therapy (A-RT) appears to improve outcomes in locally advanced pancreatic cancer (LAPC) yet requires solutions for respiratory and digestive motion. We report outcomes of A-RT for pancreatic cancer using 1.5 T MR-adaptive treatment delivery. Between March 2020 and July 2021, we treated 30 patients with pancreatic cancer with 50 Gy in 5 fractions (biologically effective dose [BED10] = 100 Gy10) using a novel compression belt workflow and remote planning on the Unity 1.5 T MR linac system. Cumulative incidence of progression was computed from A-RT initiation with death as a competing risk. Overall (OS) and progression-free survival (PFS) were calculated using Kaplan Meier methods. Of 30 patients, most (73 %) were locally advanced, 4 (13 %) were metastatic, 2 (7 %) were medically inoperable, and 2 (7 %) were locally recurrent. Most (73 %) received FOLFIRINOX prior to A-RT. Median follow-up times from diagnosis and A-RT were 17.6 (IQR 15.8–23.1) and 11.5 months (IQR 9.7–16.1), respectively. Cumulative incidences at 1-year of local and distant progression were 19.3 % (95 %CI 6.7–36.8 %) and 47.4 % (95 %CI 26.7–65.6 %), respectively. Median OS from diagnosis and A-RT were not reached. One-year OS from diagnosis and A-RT were 96.4 % (95 %CI 77.2–99.5 %) and 80.0 % (95 %CI 57.3–91.4 %), respectively. Median and 1-year PFS were 10.1 months (95 %CI 4.4–14.4) and 39.7 % (95 %CI 20.3–58.5 %), respectively. No grade 3 + toxicities were observed. A-RT using the 1.5 T Unity MR Linac resulted in promising LC and OS with no severe toxicity in patients with LAPC despite radiosensitive organs adjacent to the target volumes. Longer follow-up is needed to assess long-term outcomes.
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影响因子：
5.7
作者：
Teriaca, M. A.;Loi, M.;Nuyttens, J. J.
通讯作者：
Nuyttens, J. J.
DOI：
10.1016/j.tipsro.2020.06.001
发表时间：
2020-09-01
影响因子：
--
作者：
Placidi, Lorenzo;Romano, Angela;Valentini, Vincenzo
通讯作者：
Valentini, Vincenzo
DOI：
10.1016/j.ijrobp.2015.12.003
发表时间：
2016-03-15
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Krishnan S;Chadha AS;Suh Y;Chen HC;Rao A;Das P;Minsky BD;Mahmood U;Delclos ME;Sawakuchi GO;Beddar S;Katz MH;Fleming JB;Javle MM;Varadhachary GR;Wolff RA;Crane CH
通讯作者：
Crane CH
影响因子：
2.3
作者：
Hassanzadeh C;Rudra S;Bommireddy A;Hawkins WG;Wang-Gillam A;Fields RC;Cai B;Park J;Green O;Roach M;Henke L;Kim H
通讯作者：
Kim H
影响因子：
5.7
作者：
Henke, Lauren;Kashani, Rojano;Olsen, Jeffrey
通讯作者：
Olsen, Jeffrey