Journal article
Direct-to-Unit Stereotactic Magnetic Resonance Imaging-Guided Adaptive Radiation Therapy for Spine Metastasis
International journal of radiation oncology, biology, physics, Vol.124(5), pp.1233-1238
04/01/2026
DOI: 10.1016/j.ijrobp.2025.11.043
PMID: 41325873
Abstract
Purpose: This study evaluated the feasibility of a direct-to-unit stereotactic magnetic resonance imaging-guided adaptive radiation therapy (SMART) workflow for spine metastases. Methods and Materials: Ten patients with spinal metastases were prospectively enrolled. Preplans were created using diagnostic imaging, with patients proceeding directly to magnetic resonance imaging-guided adaptive treatment using online adaptation and bulk density override for dose calculation. Feasibility was defined as successful completion of the first fraction on the initial on-table attempt in ≥70% of patients. Toxicity, dosimetric outcomes, and clinical response were assessed. Results: Delivery of first fraction on first attempt was successful 90% of the time. Of 36 total fractions, 10 required online adaptation. The median treatment time per fraction was 87 minutes. Acute toxicity was limited to grade 1 to 2 fatigue. At a median follow-up of 14 months, local control was 90% at 3 months and 67% at 6 months. Conclusions: Direct-to-unit SMART is a feasible and safe approach for spine stereotactic body radiation therapy, allowing treatment without conventional simulation.
Details
- Title: Subtitle
- Direct-to-Unit Stereotactic Magnetic Resonance Imaging-Guided Adaptive Radiation Therapy for Spine Metastasis
- Creators
- Weiren Liu - Washington University in St. LouisEric D. Morris - Washington University in St. LouisJoshua P. Schiff - Keck Hospital of USCEric Laugeman - Washington University in St. LouisAlex T. Price - University Hospitals of ClevelandOlga Green - Endeavor HealthKaren Miller - Washington University in St. LouisBrandi Jansen - Washington University in St. LouisSai Duriseti - UCLA HealthSouman Rudra - Emory UniversityShahed N. Badiyan - Southwestern Medical CenterPamela P. Samson - Washington University in St. LouisHyun Kim - Washington University in St. LouisLauren E. Henke - University Hospitals of ClevelandClifford G. Robinson - Washington University in St. Louis
- Resource Type
- Journal article
- Publication Details
- International journal of radiation oncology, biology, physics, Vol.124(5), pp.1233-1238
- DOI
- 10.1016/j.ijrobp.2025.11.043
- PMID
- 41325873
- NLM abbreviation
- Int J Radiat Oncol Biol Phys
- ISSN
- 0360-3016
- eISSN
- 1879-355X
- Number of pages
- 6
- Grant note
- Washington University in St. Louis (http://data.elsevier.com/vocabulary/SciValFunders/100007268) UNC Department of Radiation Oncology (http://data.elsevier.com/vocabulary/SciValFunders/100030622) School of Medicine, Washington University in St. Louis (http://data.elsevier.com/vocabulary/SciValFunders/100011912)
- Language
- English
- Date published
- 04/01/2026
- Academic Unit
- Radiation Oncology
- Record Identifier
- 9985223622902771
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