Planning evaluation of stereotactic magnetic resonance-guided online adaptive radiosurgery for kidney tumors close to the organ at risk: is it valuable to wait for good timing to perform stereotactic radiosurgery?

• 발행기관: 대한방사선종양학회
• 저자명: Takaya Yamamoto Shohei Tanaka Noriyoshi Takahashi Rei Umezawa Yu Suzuki Keita Kishida So Omata Kazuya Takeda Hinako Harada Kiyokazu Sato Yoshiyuki Katsuta Noriyuki Kadoya Keiichi Jingu
• 간행물 정보: 『대한방사선종양학회지』제43권 제1호, 40~48쪽, 전체 9쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2025.03.31

국문 초록

Purpose: This study aimed to investigate changes in target coverage using magnetic resonance-guided online adaptive radiotherapy (MRgoART) for kidney tumors and to evaluate the suitable timing of treatment. Materials and Methods: Among patients treated with 3-fraction MRgoART for kidney cancer, 18 tumors located within 1 cm of the gastrointestinal tract were selected. Stereotactic radiosurgery planning with a prescription dose of 26 Gy was performed using pretreatment simulation and three MRgoART timings with an adapt-to-shape method. The best MRgoART plan was defined as the plan achieving the highest percentage of planning target volume (PTV) coverage of 26 Gy. In clinical scenario simulation, MRgoART plans were evaluated in the order of actual treatment. Waiting for the next timing was done when the PTV coverage of 26 Gy did not achieve 95%-99% or did not increase by 5% or more compared to the pretreatment plan. Results: The median percentages of PTV receiving 26 Gy in pretreatment and the first, second, and third MRgoART were 82% (range, 1 to 99), 63% (range, 7 to 99), 88% (range, 31 to 99), and 95% (range, 3 to 99), respectively. Comparing pretreatment simulation plans with the best MRgoART plans showed a significant difference (p = 0.025). In the clinical scenario simulation, 16 of the 18 planning series, including nine plans with 95%-99% PTV coverage of 26 Gy and seven plans with increased PTV coverage by 5% or more, would be irradiated at a good timing. Conclusion: MRgoART revealed dose coverage differences at each MRgoART timing. Waiting for optimal irradiation timing could be an option in case of suboptimal timing.

목차

Introduction

Materials and Methods

Results

Discussion and Conclusion

Statement of Ethics

Conflict of Interest

Acknowledgments

Funding

Author Contributions

Data Availability Statement

Supplementary Materials

References

키워드

Radiotherapy Stereotactic technique Kidney cancer Radiotherapy planning MR-Linac MR-guided online adaptive radiotherapy