Journal article
The potential role of MR-guided adaptive radiotherapy in pediatric oncology: Results from a SIOPE-COG survey
Clinical and translational radiation oncology, Vol.29, pp.71-78
07/2021
DOI: 10.1016/j.ctro.2021.05.008
PMCID: PMC8202186
PMID: 34159265
Abstract
•An international survey assessed the potential role of MRgRT in pediatrics.•The Dutch National cohort has been used to put results into a clinical perspective.•A potential toxicity/outcome benefit is expected for 55%/24% of primary sites.•A potential toxicity/outcome benefit is expected for 62%/38% of metastatic sites.•Consortium-based collaboration is essential to validate expectations.
Magnetic resonance guided radiotherapy (MRgRT) has been successfully implemented for several routine clinical applications in adult patients. The purpose of this study is to map the potential benefit of MRgRT on toxicity reduction and outcome in pediatric patients treated with curative intent for primary and metastatic sites.
Between May and August 2020, a survey was distributed among SIOPE- and COG-affiliated radiotherapy departments, treating at least 25 pediatrics patients annually and being (candidate) users of a MRgRT system. The survey consisted of a table with 45 rows (clinical scenarios for primary (n = 28) and metastatic (n = 17) tumors) and 7 columns (toxicity reduction, outcome improvement, PTV margin reduction, target volume daily adaptation, online re-planning, intrafraction motion compensation and on-board functional imaging) and the option to answer by ‘yes/no’ . Afterwards, the Dutch national radiotherapy cohort was used to estimate the percentage of pediatric treatments that may benefit from MRgRT.
The survey was completed by 12/17 (71% response rate) institutions meeting the survey inclusion criteria. Responders indicated an ‘expected benefit’ from MRgRT for toxicity/outcome in 7% (for thoracic lymphomas and abdominal rhabdomyosarcomas)/0% and 18% (for mediastinal lymph nodes, lymph nodes located in the liver/splenic hilum, and liver metastases)/0% of the considered scenarios for the primary and metastatic tumor sites, respectively, and a ‘possible benefit’ was estimated in 64%/46% and 47%/59% of the scenarios. When translating the survey outcome into a clinical perspective a toxicity/outcome benefit, either expected or possible, was anticipated for 55%/24% of primary sites and 62%/38% of the metastatic sites.
Although the benefit of MRgRT in pediatric radiation oncology is estimated to be modest, the potential role for reducing toxicity and improving clinical outcomes warrants further investigation. This fits best within the context of prospective studies or registration trials.
Details
- Title: Subtitle
- The potential role of MR-guided adaptive radiotherapy in pediatric oncology: Results from a SIOPE-COG survey
- Creators
- Enrica Seravalli - Department of Radiation-Oncology, University Medical Center Utrecht, Utrecht, The NetherlandsPetra S. Kroon - Department of Radiation-Oncology, University Medical Center Utrecht, Utrecht, The NetherlandsJohn M. Buatti - University of IowaMatthew D. Hall - Department of Radiation Oncology, Miami Cancer Institute, Miami, FL, USAHenry C. Mandeville - Department of Radiotherapy, The Royal Marsden Hospital and Institute of Cancer Research, Sutton, United KingdomKaren J. Marcus - Dana-Farber/Boston Children's Cancer and Blood Disorders CenterCem Onal - Başkent UniversityEnis Ozyar - Department of Radiation Oncology, Acibadem Mehmet Ali Aydinlar University, Istanbul, TurkeyArnold C. Paulino - The University of Texas MD Anderson Cancer CenterFrank Paulsen - University of TübingenDaniel Saunders - Christie Hospital NHS Foundation TrustDerek S. Tsang - Princess Margaret Cancer CentreSuzanne L. Wolden - Memorial Sloan Kettering Cancer CenterGeert O. Janssens - University Medical Center Utrecht
- Resource Type
- Journal article
- Publication Details
- Clinical and translational radiation oncology, Vol.29, pp.71-78
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.ctro.2021.05.008
- PMID
- 34159265
- PMCID
- PMC8202186
- ISSN
- 2405-6308
- eISSN
- 2405-6308
- Language
- English
- Date published
- 07/2021
- Academic Unit
- Radiation Oncology; Neurosurgery; Otolaryngology
- Record Identifier
- 9984304037402771
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