Online adaptive radiotherapy for head and neck cancers on the MR linear Accelerator: Introducing a novel modified Adapt-to-Shape approach.
Online adaptive radiotherapy for head and neck cancers on the MR linear Accelerator: Introducing a novel modified Adapt-to-Shape approach.
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DOI：
10.1016/j.ctro.2021.11.001
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发表时间：
2022-01
影响因子：
3.1
通讯作者：
Wong KH
中科院分区：
文献类型：
--
作者：
Gupta A;Dunlop A;Mitchell A;McQuaid D;Nill S;Barnes H;Newbold K;Nutting C;Bhide S;Oelfke U;Harrington KJ;Wong KH
MR-直线加速器提供了在线MR引导自适应放射治疗的工具。Adap-to-Shape-Lite是Elekta Unity MR-直线加速器Adap-to-Shape-Lite生成计划的一种新型放射治疗计划工作流程，满足99.9%的强制剂量约束。Adap-to-Shape-Lite工作流程可以在相对较短的持续时间内生成计划。因此，Elekta Unity MR-Linac（MRL）为头颈癌（HNC）患者提供了自适应放射治疗（ART）。Adapt-To-Shape-Lite（ATS-Lite）是一种新型的Adapt-to-Shape策略，可提供ART，而无需临床医生每天到场进行在线靶和危及器官（OAR）勾画。在这项研究中，我们比较了我们的临床交付的ATS-Lite策略与三种适应位置（ATP）变体的性能：适应片段（ATP-AS），优化权重（ATP-OW）和优化权重（ATP-OS）。2例HNC患者在MRL上接受了自由基剂量放疗。对于每个馏分，在线生成并交付ATS-Lite计划，并为每个ATP变体离线生成其他计划。为了评估每个部分的计划的临床可接受性，对所有四个计划的目标和OAR的20个临床目标进行了评估。分析了53个馏分。ATS-Lite通过了99.9%的强制剂量限制。ATP-AS和ATP-OW各有7.6%的强制剂量限制失败。54戈伊的计划目标剂量（D95%和D98%）是ATP最常失败的剂量限制目标。患者1和2的ATS-Lite中位分数时间分别为40分钟9秒（范围28分钟16秒- 47分钟20秒）和32分钟14秒（范围25分钟33秒- 44分钟27秒）。我们的早期数据表明，新的ATS-Lite策略产生的计划在患者可耐受的时间范围内满足99.9%的临床剂量限制，与ATP工作流程相当。因此，将在我们研究所内进一步使用和开发ATS-Lite，它弥补了ATP和全ATS之间的差距，并且是治疗MRL上HNC患者时应考虑的工作流程。
The MR-Linac provides the tools to deliver online MR-guided Adaptive Radiotherapy Adapt-to-Shape-Lite is a novel radiotherapy planning workflow on the Elekta Unity MR-Linac Adapt-to-Shape-Lite generated plans that fulfilled 99.9% of mandatory dose constraints Adapt-to-Shape-Lite workflow can generate plans in relatively short durations Therefore, we prefer Adapt-To-Shape-Lite as the primary workflow to treat Head-and-Neck cancers The Elekta Unity MR-Linac (MRL) has enabled adaptive radiotherapy (ART) for patients with head and neck cancers (HNC). Adapt-To-Shape-Lite (ATS-Lite) is a novel Adapt-to-Shape strategy that provides ART without requiring daily clinician presence to perform online target and organ at risk (OAR) delineation. In this study we compared the performance of our clinically-delivered ATS-Lite strategy against three Adapt-To-Position (ATP) variants: Adapt Segments (ATP-AS), Optimise Weights (ATP-OW), and Optimise Shapes (ATP-OS). Two patients with HNC received radical-dose radiotherapy on the MRL. For each fraction, an ATS-Lite plan was generated online and delivered and additional plans were generated offline for each ATP variant. To assess the clinical acceptability of a plan for every fraction, twenty clinical goals for targets and OARs were assessed for all four plans. 53 fractions were analysed. ATS-Lite passed 99.9% of mandatory dose constraints. ATP-AS and ATP-OW each failed 7.6% of mandatory dose constraints. The Planning Target Volumes for 54 Gy (D95% and D98%) were the most frequently failing dose constraint targets for ATP. ATS-Lite median fraction times for Patient 1 and 2 were 40 mins 9 s (range 28 mins 16 s – 47 mins 20 s) and 32 mins 14 s (range 25 mins 33 s – 44 mins 27 s), respectively. Our early data show that the novel ATS-Lite strategy produced plans that fulfilled 99.9% of clinical dose constraints in a time frame that is tolerable for patients and comparable to ATP workflows. Therefore, ATS-Lite, which bridges the gap between ATP and full ATS, will be further utilised and developed within our institute and it is a workflow that should be considered for treating patients with HNC on the MRL.
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DOI：
10.1016/j.ijrobp.2020.12.015
发表时间：
2021-04-01
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
McDonald BA;Vedam S;Yang J;Wang J;Castillo P;Lee B;Sobremonte A;Ahmed S;Ding Y;Mohamed ASR;Balter P;Hughes N;Thorwarth D;Nachbar M;Philippens MEP;Terhaard CHJ;Zips D;Böke S;Awan MJ;Christodouleas J;Fuller CD;MR-Linac Consortium Head and Neck Tumor Site Group
通讯作者：
MR-Linac Consortium Head and Neck Tumor Site Group
影响因子：
3.1
作者：
Dunlop, Alex;Mitchell, Adam;Oelfke, Uwe
通讯作者：
Oelfke, Uwe
DOI：
10.1007/s00066-015-0890-7
发表时间：
2015-12
期刊：
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
影响因子：
--
作者：
Dunlop A;McQuaid D;Nill S;Murray J;Poludniowski G;Hansen VN;Bhide S;Nutting C;Harrington K;Newbold K;Oelfke U
通讯作者：
Oelfke U
影响因子：
3.1
作者：
Bertelsen, Anders S.;Schytte, Tine;Bernchou, Uffe
通讯作者：
Bernchou, Uffe
影响因子：
51.1
作者：
Nutting, Christopher M.;Morden, James P.;Harrington, Kevin J.;Urbano, Teresa Guerrero;Bhide, Shreerang A.;Clark, Catharine;Miles, Elizabeth A.;Miah, Aisha B.;Newbold, Kate;Tanay, MaryAnne;Adab, Fawzi;Jefferies, Sarah J.;Scrase, Christopher;Yap, Beng K.;A'Hern, Roger P.;Sydenham, Mark A.;Emson, Marie;Hall, Emma
通讯作者：
Hall, Emma