Adaptive radiotherapy for oropharyngeal cancer with daily adapt-to-shape workflow on 1.5 T MRI-linac: Preliminary outcomes and comparison with helical tomotherapy
Introduction: MR-linac could offer several advantages for radical radiochemotherapy (RCHT) in oropharyngeal squamous cell carcinoma (OPSCC) patients. Currently, only a few case series have been published and no comparison with other techniques have been performed. Methods: Data of 34 consecutive pat...
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Elsevier
2025-07-01
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| Series: | Clinical and Translational Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630825000400 |
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| author | Andrea Emanuele Guerini Michela Buglione Stefania Nici Stefano Riga Ludovica Pegurri Eneida Mataj Davide Farina Marco Ravanelli Paolo Rondi Gianluca Cossali Davide Tomasini Luca Triggiani Giorgio Facheris Luigi Spiazzi Stefano Maria Magrini |
| author_facet | Andrea Emanuele Guerini Michela Buglione Stefania Nici Stefano Riga Ludovica Pegurri Eneida Mataj Davide Farina Marco Ravanelli Paolo Rondi Gianluca Cossali Davide Tomasini Luca Triggiani Giorgio Facheris Luigi Spiazzi Stefano Maria Magrini |
| author_sort | Andrea Emanuele Guerini |
| collection | DOAJ |
| description | Introduction: MR-linac could offer several advantages for radical radiochemotherapy (RCHT) in oropharyngeal squamous cell carcinoma (OPSCC) patients. Currently, only a few case series have been published and no comparison with other techniques have been performed. Methods: Data of 34 consecutive patients treated from September 2022 to May 2024 at a single Institution with RCHT on Unity® MR-linac for OPSCC with daily adaptive radiotherapy (RT) according to the adapt-to-shape (ATS) workflow were prospectively analyzed. A comparative cohort of 34 patients with similar characteristics treated with helical treatment on Radixact® was retrieved. Results: Characteristics were well balanced across the two groups. Maximal toxicity grade ≥2 rate was borderline higher at RT end in MRI-linac group (p 0.049), but lower one month after RT (76.5 % vs 91.2 %; p = 0.257).Non-significantly lower rates of grade ≥2 xerostomia and dysgeusia were reported in Unity® group one and three months after RT. Higher rates of hospitalizations were reported in Radixact group at 20 fractions and at RT end (64.1 % vs 35.3 %; p = 0.015). Mean Karnofsky performance status (KPS) was higher in Unity group three months after RT (87.67 vs 83.87; p = 0.038).After a median follow up of 361.5 days, local complete response was reported for 93.6 % of patients treated with Unity® and 96.8 % of patients treated with Radixact®. Conclusions: Results of this analysis support the feasibility of an ATS MR-linac workflow for RCHT in OPSCC. Compared with tomotherapy, treatment with Unity® resulted in significantly lower rates of hospitalization and higher KPS three months after RT. Grade 2 xerostomia and dysgeusia rates were non-significantly lower in Unity group. Optimal results in terms of local control were reported for both techniques. |
| format | Article |
| id | doaj-art-66cefd2a2c0d49bc9201d2adf630dd87 |
| institution | OA Journals |
| issn | 2405-6308 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical and Translational Radiation Oncology |
| spelling | doaj-art-66cefd2a2c0d49bc9201d2adf630dd872025-08-20T02:10:02ZengElsevierClinical and Translational Radiation Oncology2405-63082025-07-015310095010.1016/j.ctro.2025.100950Adaptive radiotherapy for oropharyngeal cancer with daily adapt-to-shape workflow on 1.5 T MRI-linac: Preliminary outcomes and comparison with helical tomotherapyAndrea Emanuele Guerini0Michela Buglione1Stefania Nici2Stefano Riga3Ludovica Pegurri4Eneida Mataj5Davide Farina6Marco Ravanelli7Paolo Rondi8Gianluca Cossali9Davide Tomasini10Luca Triggiani11Giorgio Facheris12Luigi Spiazzi13Stefano Maria Magrini14Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; Corresponding author.Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; Centro per lo Studio della Radioterapia guidata dalle Immagini e dai Biomarkers (BIO-RT) – Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica – University of Brescia, ItalyMedical Physics Department, ASST Spedali Civili Hospital, Brescia, ItalyMedical Physics Department, ASST Spedali Civili Hospital, Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, ItalyRadiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, ItalyRadiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, ItalyRadiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili, Piazzale Spedali Civili 1, 25123 Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, ItalyMedical Physics Department, ASST Spedali Civili Hospital, Brescia, Italy; Centro per lo Studio della Radioterapia guidata dalle Immagini e dai Biomarkers (BIO-RT) – Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica – University of Brescia, ItalyDepartment of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Piazzale Spedali Civili 1, 25123 Brescia, Italy; Centro per lo Studio della Radioterapia guidata dalle Immagini e dai Biomarkers (BIO-RT) – Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica – University of Brescia, ItalyIntroduction: MR-linac could offer several advantages for radical radiochemotherapy (RCHT) in oropharyngeal squamous cell carcinoma (OPSCC) patients. Currently, only a few case series have been published and no comparison with other techniques have been performed. Methods: Data of 34 consecutive patients treated from September 2022 to May 2024 at a single Institution with RCHT on Unity® MR-linac for OPSCC with daily adaptive radiotherapy (RT) according to the adapt-to-shape (ATS) workflow were prospectively analyzed. A comparative cohort of 34 patients with similar characteristics treated with helical treatment on Radixact® was retrieved. Results: Characteristics were well balanced across the two groups. Maximal toxicity grade ≥2 rate was borderline higher at RT end in MRI-linac group (p 0.049), but lower one month after RT (76.5 % vs 91.2 %; p = 0.257).Non-significantly lower rates of grade ≥2 xerostomia and dysgeusia were reported in Unity® group one and three months after RT. Higher rates of hospitalizations were reported in Radixact group at 20 fractions and at RT end (64.1 % vs 35.3 %; p = 0.015). Mean Karnofsky performance status (KPS) was higher in Unity group three months after RT (87.67 vs 83.87; p = 0.038).After a median follow up of 361.5 days, local complete response was reported for 93.6 % of patients treated with Unity® and 96.8 % of patients treated with Radixact®. Conclusions: Results of this analysis support the feasibility of an ATS MR-linac workflow for RCHT in OPSCC. Compared with tomotherapy, treatment with Unity® resulted in significantly lower rates of hospitalization and higher KPS three months after RT. Grade 2 xerostomia and dysgeusia rates were non-significantly lower in Unity group. Optimal results in terms of local control were reported for both techniques.http://www.sciencedirect.com/science/article/pii/S2405630825000400MR-linacMRI-linacHead and neckOropharyngealOropharynxAdaptive radiotherapy |
| spellingShingle | Andrea Emanuele Guerini Michela Buglione Stefania Nici Stefano Riga Ludovica Pegurri Eneida Mataj Davide Farina Marco Ravanelli Paolo Rondi Gianluca Cossali Davide Tomasini Luca Triggiani Giorgio Facheris Luigi Spiazzi Stefano Maria Magrini Adaptive radiotherapy for oropharyngeal cancer with daily adapt-to-shape workflow on 1.5 T MRI-linac: Preliminary outcomes and comparison with helical tomotherapy Clinical and Translational Radiation Oncology MR-linac MRI-linac Head and neck Oropharyngeal Oropharynx Adaptive radiotherapy |
| title | Adaptive radiotherapy for oropharyngeal cancer with daily adapt-to-shape workflow on 1.5 T MRI-linac: Preliminary outcomes and comparison with helical tomotherapy |
| title_full | Adaptive radiotherapy for oropharyngeal cancer with daily adapt-to-shape workflow on 1.5 T MRI-linac: Preliminary outcomes and comparison with helical tomotherapy |
| title_fullStr | Adaptive radiotherapy for oropharyngeal cancer with daily adapt-to-shape workflow on 1.5 T MRI-linac: Preliminary outcomes and comparison with helical tomotherapy |
| title_full_unstemmed | Adaptive radiotherapy for oropharyngeal cancer with daily adapt-to-shape workflow on 1.5 T MRI-linac: Preliminary outcomes and comparison with helical tomotherapy |
| title_short | Adaptive radiotherapy for oropharyngeal cancer with daily adapt-to-shape workflow on 1.5 T MRI-linac: Preliminary outcomes and comparison with helical tomotherapy |
| title_sort | adaptive radiotherapy for oropharyngeal cancer with daily adapt to shape workflow on 1 5 t mri linac preliminary outcomes and comparison with helical tomotherapy |
| topic | MR-linac MRI-linac Head and neck Oropharyngeal Oropharynx Adaptive radiotherapy |
| url | http://www.sciencedirect.com/science/article/pii/S2405630825000400 |
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