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dc.contributor.authorGani, C
dc.contributor.authorBoeke, S
dc.contributor.authorMcNair, H
dc.contributor.authorEhlers, J
dc.contributor.authorNachbar, M
dc.contributor.authorMönnich, D
dc.contributor.authorStolte, A
dc.contributor.authorBoldt, J
dc.contributor.authorMarks, C
dc.contributor.authorWinter, J
dc.contributor.authorKünzel, LA
dc.contributor.authorGatidis, S
dc.contributor.authorBitzer, M
dc.contributor.authorThorwarth, D
dc.contributor.authorZips, D
dc.date.accessioned2021-03-30T14:03:48Z
dc.date.available2021-03-30T14:03:48Z
dc.identifier.citationClinical and translational radiation oncology, 2021, 26 pp. 55 - 61
dc.identifier.issn2405-6308
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/4467
dc.identifier.eissn2405-6308
dc.identifier.doi10.1016/j.ctro.2020.11.014
dc.description.abstractIntroduction Stereotactic body radiotherapy (SBRT) is an established ablative treatment for liver tumors with excellent local control rates. Magnetic resonance imaging guided radiotherapy (MRgRT) provides superior soft tissue contrast and may therefore facilitate a marker-less liver SBRT workflow. The goal of the present study was to investigate feasibility, workflow parameters, toxicity and patient acceptance of MRgSBRT on a 1.5 T MR-Linac.Methods Ten consecutive patients with liver metastases treated on a 1.5 T MR-Linac were included in this prospective trial. Tumor delineation was performed on four-dimensional computed tomography scans and both exhale triggered and free-breathing T2 MRI scans from the MR-Linac. An internal target volume based approach was applied. Organ at risk constraints were based on the UKSABR guidelines (Version 6.1). Patient acceptance regarding device specific aspects was assessed and toxicity was scored according to the common toxicity criteria of adverse events, version 5.Results Nine of ten tumors were clearly visible on the 1.5 T MR-Linac. No patient had fiducial markers placed for treatment. All patients were treated with three or five fractions. Median dose to 98% of the gross tumor volume was 38.5 Gy. The median time from "patient identity check" until "beam-off" was 31 min. Median beam on time was 9.6 min. Online MRgRT was well accepted in general and no treatment had to be interrupted on patient request. No event of symptomatic radiation induced liver disease was observed after a median follow-up of ten month (range 3-17 months).Conclusion Our early experience suggests that online 1.5 T MRgSBRT of liver metastases represents a promising new non-invasive marker-free treatment modality based on high image quality, clinically reasonable in-room times and high patient acceptance. Further studies are necessary to assess clinical outcome, to validate advanced motion management and to explore the benefit of online response adaptive liver SBRT.
dc.formatElectronic-eCollection
dc.format.extent55 - 61
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleMarker-less online MR-guided stereotactic body radiotherapy of liver metastases at a 1.5 T MR-Linac - Feasibility, workflow data and patient acceptance.
dc.typeJournal Article
dcterms.dateAccepted2020-11-24
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1016/j.ctro.2020.11.014
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc-nd/4.0
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfClinical and translational radiation oncology
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume26
pubs.embargo.termsNot known
dc.contributor.icrauthorMcNair, Helen


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