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dc.contributor.authorBahig, Hen_US
dc.contributor.authorYuan, Yen_US
dc.contributor.authorMohamed, ASRen_US
dc.contributor.authorBrock, KKen_US
dc.contributor.authorNg, SPen_US
dc.contributor.authorWang, Jen_US
dc.contributor.authorDing, Yen_US
dc.contributor.authorHutcheson, Ken_US
dc.contributor.authorMcCulloch, Men_US
dc.contributor.authorBalter, PAen_US
dc.contributor.authorLai, SYen_US
dc.contributor.authorAl-Mamgani, Aen_US
dc.contributor.authorSonke, J-Jen_US
dc.contributor.authorvan der Heide, UAen_US
dc.contributor.authorNutting, Cen_US
dc.contributor.authorLi, XAen_US
dc.contributor.authorRobbins, Jen_US
dc.contributor.authorAwan, Men_US
dc.contributor.authorKaram, Ien_US
dc.contributor.authorNewbold, Ken_US
dc.contributor.authorHarrington, Ken_US
dc.contributor.authorOelfke, Uen_US
dc.contributor.authorBhide, Sen_US
dc.contributor.authorPhilippens, MEPen_US
dc.contributor.authorTerhaard, CHJen_US
dc.contributor.authorMcPartlin, AJen_US
dc.contributor.authorBlanchard, Pen_US
dc.contributor.authorGarden, ASen_US
dc.contributor.authorRosenthal, DIen_US
dc.contributor.authorGunn, GBen_US
dc.contributor.authorPhan, Jen_US
dc.contributor.authorCazoulat, Gen_US
dc.contributor.authorAristophanous, Men_US
dc.contributor.authorMcSpadden, KKen_US
dc.contributor.authorGarcia, JAen_US
dc.contributor.authorvan den Berg, CATen_US
dc.contributor.authorRaaijmakers, CPJen_US
dc.contributor.authorKerkmeijer, Len_US
dc.contributor.authorDoornaert, Pen_US
dc.contributor.authorBlinde, Sen_US
dc.contributor.authorFrank, SJen_US
dc.contributor.authorFuller, CDen_US
dc.coverage.spatialIrelanden_US
dc.date.accessioned2019-02-04T14:53:30Z
dc.date.issued2018-11en_US
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/30386824en_US
dc.identifierS2405-6308(18)30048-Xen_US
dc.identifier.citationClin Transl Radiat Oncol, 2018, 13 pp. 19 - 23en_US
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3044
dc.identifier.eissn2405-6308en_US
dc.identifier.doi10.1016/j.ctro.2018.08.003en_US
dc.description.abstractBackground: Current standard radiotherapy for oropharynx cancer (OPC) is associated with high rates of severe toxicities, shown to adversely impact patients' quality of life. Given excellent outcomes of human papilloma virus (HPV)-associated OPC and long-term survival of these typically young patients, treatment de-intensification aimed at improving survivorship while maintaining excellent disease control is now a central concern. The recent implementation of magnetic resonance image - guided radiotherapy (MRgRT) systems allows for individual tumor response assessment during treatment and offers possibility of personalized dose-reduction. In this 2-stage Bayesian phase II study, we propose to examine weekly radiotherapy dose-adaptation based on magnetic resonance imaging (MRI) evaluated tumor response. Individual patient's plan will be designed to optimize dose reduction to organs at risk and minimize locoregional failure probability based on serial MRI during RT. Our primary aim is to assess the non-inferiority of MRgRT dose adaptation for patients with low risk HPV-associated OPC compared to historical control, as measured by Bayesian posterior probability of locoregional control (LRC). Methods: Patients with T1-2 N0-2b (as per AJCC 7th Edition) HPV-positive OPC, with lymph node <3 cm and <10 pack-year smoking history planned for curative radiotherapy alone to a dose of 70 Gy in 33 fractions will be eligible. All patients will undergo pre-treatment MRI and at least weekly intra-treatment MRI. Patients undergoing MRgRT will have weekly adaptation of high dose planning target volume based on gross tumor volume response. The stage 1 of this study will enroll 15 patients to MRgRT dose adaptation. If LRC at 6 months with MRgRT dose adaptation is found sufficiently safe as per the Bayesian model, stage 2 of the protocol will expand enrollment to an additional 60 patients, randomized to either MRgRT or standard IMRT. Discussion: Multiple methods for safe treatment de-escalation in patients with HPV-positive OPC are currently being studied. By leveraging the ability of advanced MRI techniques to visualize tumor and soft tissues through the course of treatment, this protocol proposes a workflow for safe personalized radiation dose-reduction in good responders with radiosensitive tumors, while ensuring tumoricidal dose to more radioresistant tumors. MRgRT dose adaptation could translate in reduced long term radiation toxicities and improved survivorship while maintaining excellent LRC outcomes in favorable OPC. Trial registration: ClinicalTrials.gov ID: NCT03224000; Registration date: 07/21/2017.en_US
dc.format.extent19 - 23en_US
dc.languageengen_US
dc.language.isoengen_US
dc.subjectAdaptive radiotherapyen_US
dc.subjectHuman papilloma virusen_US
dc.subjectMagnetic resonance imaging guided radiotherapyen_US
dc.subjectOropharyngeal canceren_US
dc.titleMagnetic Resonance-based Response Assessment and Dose Adaptation in Human Papilloma Virus Positive Tumors of the Oropharynx treated with Radiotherapy (MR-ADAPTOR): An R-IDEAL stage 2a-2b/Bayesian phase II trial.en_US
dc.typeJournal Article
dcterms.dateAccepted2018-08-22en_US
rioxxterms.versionofrecord10.1016/j.ctro.2018.08.003en_US
rioxxterms.licenseref.startdate2018-11en_US
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfClin Transl Radiat Oncolen_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Biology/Targeted Therapy
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Radiotherapy Physics Modelling
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Targeted Therapy
pubs.publication-statusPublished onlineen_US
pubs.volume13en_US
pubs.embargo.termsNot knownen_US
icr.researchteamRadiotherapy Physics Modellingen_US
icr.researchteamTargeted Therapyen_US
dc.contributor.icrauthorOelfke, Uween_US
dc.contributor.icrauthorHarrington, Kevinen_US


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