Preliminary experience using MR-guided adaptive radiotherapy in head and neck cancer

Caiden Atienza; Andrew Shepard; Uwajachukwumma Uzomah; Shri Kiriti Rajan; Carryn M. Anderson; Joel Katzer; Samuel Rusu; Joel St-Aubin; Blake Smith; Daniel Hyer

doi:10.3389/fonc.2024.1474115

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Preliminary experience using MR-guided adaptive radiotherapy in head and neck cancer

Journal article

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Peer reviewed

Preliminary experience using MR-guided adaptive radiotherapy in head and neck cancer

Caiden Atienza, Andrew Shepard, Uwajachukwumma Uzomah, Shri Kiriti Rajan, Carryn M. Anderson, Joel Katzer, Samuel Rusu, Joel St-Aubin, Blake Smith and Daniel Hyer

Frontiers in oncology, Vol.14, 1474115

11/08/2024

DOI: 10.3389/fonc.2024.1474115

PMCID: PMC11582005

PMID: 39582545

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Abstract

This retrospective study evaluates the dosimetric benefits of adaptive radiotherapy for head and neck cancer patients. Five patients with node-positive oropharyngeal squamous cell carcinoma were treated with MR-guided radiotherapy using the Elekta Unity MR-Linac, undergoing 3-4 offline adaptive plan modifications during their treatment. This study compared the dose delivered to organs at risk (OARs) in a full offline adaptive approach versus an approach accounting only for daily setup. Results demonstrated a reduction in mean dose to critical structures in the offline adaptive arm. For example, the pharynx avoidance structure showed mean dose reductions ranging from 1.4 Gy to 3.6 Gy, and the left parotid gland exhibited reductions from 1.5 Gy to 1.9 Gy. Overall, offline adaptive radiotherapy reduced the mean cumulative dose to OARs in 19 of the 23 evaluated structures. Despite some instances of higher doses, the offline adaptive approach generally resulted in lower cumulative doses, emphasizing its potential to mitigate radiation-induced side effects. These findings suggest that offline adaptive radiotherapy has the potential to enhance treatment efficacy by better accommodating anatomical changes during therapy, thereby improving patient outcomes and reducing treatment-related morbidity.

adaptive

radiotherapy

benefit

MR-linac

organs-at-risk

Details

Title: Subtitle: Preliminary experience using MR-guided adaptive radiotherapy in head and neck cancer
Creators: Caiden Atienza - University of Iowa Health Care
Andrew Shepard - University of Iowa
Uwajachukwumma Uzomah - University of Iowa Health Care
Shri Kiriti Rajan - University of Iowa
Carryn M. Anderson - University of Iowa
Joel Katzer - University of Iowa, Anesthesia
Samuel Rusu - University of Iowa
Joel St-Aubin - University of Iowa
Blake Smith - University of Iowa, Radiation Oncology
Daniel Hyer - University of Iowa
Resource Type: Journal article
Publication Details: Frontiers in oncology, Vol.14, 1474115
DOI: 10.3389/fonc.2024.1474115
PMID: 39582545
PMCID: PMC11582005
NLM abbreviation: Front Oncol
ISSN: 2234-943X
eISSN: 2234-943X
Publisher: FRONTIERS MEDIA SA; LAUSANNE
Grant note: P3 Program for Strategic PrioritiesMidwest FLASH Lab: Developing Next-Generation Radiotherapy Delivery and Expertise at the University of Iowa
This project was supported in part by the P3 Program for Strategic Priorities, specifically the Midwest FLASH Lab: Developing Next-Generation Radiotherapy Delivery and Expertise at the University of Iowa.
Language: English
Date published: 11/08/2024
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiation Oncology; Anesthesia
Record Identifier: 9984746138802771

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