Magnetic resonance linear accelerator boost for para-urethral cancer: a new treatment paradigm replacement for brachytherapy

• 발행기관: 대한방사선종양학회
• 저자명: Amir Owrangi David Chiu Star Okolie Kevin Albuquerque
• 간행물 정보: 『대한방사선종양학회지』제43권 제2호, 104~108쪽, 전체 5쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2025.06.30

국문 초록

This study evaluates the use of magnetic resonance-guided radiation therapy (MRgRT) as an alternative to brachytherapy in treating para-urethral gynecological cancers, particularly for patients who are not candidates for brachytherapy. Five female patients with advanced para-urethral gynecological cancers underwent MRgRT using a custom 3-dimensional-printed intravaginal cylinder for image registration and treatment alignment. MRgRT was administered as a five-fraction adaptive boost following standard chemoradiation, with each fraction utilizing the cylinder to achieve precise positioning and improve organ sparing. A 1.5T magnetic resonance linear accelerator was used to deliver adapt-to-shape treatment, allowing real-time adjustments to compensate for anatomical variations. The cylinder served not only as a surrogate for accurate image registration but also as a spacer to displace the rectum from high-dose regions. The median follow-up period was 14.4 months, during which all patients completed treatment with no grade >3 genitourinary toxicities. Acute toxicities included dysuria and vaginal pain, while chronic toxicities, such as urinary incontinence and mild cystitis, were recorded in a subset of patients. Treatment achieved an overall survival rate of 100% and a recurrence-free survival rate of 80%. Dosimetric analysis demonstrated effective target coverage with minimal exposure to surrounding organs, particularly sparing the urethra from hotspots, unlike traditional brachytherapy. These results suggest that MRgRT with a vaginal cylinder offers a promising approach for managing para-urethral gynecological cancers in patients ineligible for brachytherapy. Further studies are warranted to validate these findings and refine treatment protocols.

목차

Introduction

Case Report

Discussion

Statement of Ethics

Conflict of Interest

Funding

Author Contributions

Data Availability Statement

References

키워드

MR guided Radiation therapy Gynecological cancer Image registration Vaginal cylinder

참고문헌

• Radiother Oncol
• Radiother Oncol
• Radiother Oncol
• Strahlenther Onkol
• Radiother Oncol
• Lancet Oncol
• Radiat Oncol
• Clin Oncol (R Coll Radiol)