Patterns of Care, Tolerability, and Safety of the First Cohort of Patients Treated on a Novel High-Field MR-Linac Within the MOMENTUM Study: Initial Results From a Prospective Multi-Institutional Registry.
Date
2021-11-15Author
de Mol van Otterloo, SR
Christodouleas, JP
Blezer, ELA
Akhiat, H
Brown, K
Choudhury, A
Eggert, D
Erickson, BA
Daamen, LA
Faivre-Finn, C
Fuller, CD
Goldwein, J
Hafeez, S
Hall, E
Harrington, KJ
van der Heide, UA
Huddart, RA
Intven, MPW
Kirby, AM
Lalondrelle, S
McCann, C
Minsky, BD
Mook, S
Nowee, ME
Oelfke, U
Orrling, K
Philippens, MEP
Sahgal, A
Schultz, CJ
Tersteeg, RJHA
Tijssen, RHN
Tree, AC
van Triest, B
Tseng, C-L
Hall, WA
Verkooijen, HM
MR-Linac Consortium,
Type
Journal Article
Metadata
Show full item recordAbstract
PURPOSE: High-field magnetic resonance-linear accelerators (MR-Linacs), linear accelerators combined with a diagnostic magnetic resonance imaging (MRI) scanner and online adaptive workflow, potentially give rise to novel online anatomic and response adaptive radiation therapy paradigms. The first high-field (1.5T) MR-Linac received regulatory approval in late 2018, and little is known about clinical use, patient tolerability of daily high-field MRI, and toxicity of treatments. Herein we report the initial experience within the MOMENTUM Study (NCT04075305), a prospective international registry of the MR-Linac Consortium. METHODS AND MATERIALS: Patients were included between February 2019 and October 2020 at 7 institutions in 4 countries. We used descriptive statistics to describe the patterns of care, tolerability (the percentage of patients discontinuing their course early), and safety (grade 3-5 Common Terminology Criteria for Adverse Events v.5 acute toxicity within 3 months after the end of treatment). RESULTS: A total 943 patients participated in the MOMENTUM Study, 702 of whom had complete baseline data at the time of this analysis. Patients were primarily male (79%) with a median age of 68 years (range, 22-93) and were treated for 39 different indications. The most frequent indications were prostate (40%), oligometastatic lymph node (17%), brain (12%), and rectal (10%) cancers. The median number of fractions was 5 (range, 1-35). Six patients discontinued MR-Linac treatments, but none due to an inability to tolerate repeated high-field MRI. Of the 415 patients with complete data on acute toxicity at 3-month follow-up, 18 (4%) patients experienced grade 3 acute toxicity related to radiation. No grade 4 or 5 acute toxicity related to radiation was observed. CONCLUSIONS: In the first 21 months of our study, patterns of care were diverse with respect to clinical utilization, body sites, and radiation prescriptions. No patient discontinued treatment due to inability to tolerate daily high-field MRI scans, and the acute radiation toxicity experience was encouraging.
Collections
Subject
Adult
Aged
Aged, 80 and over
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Particle Accelerators
Prospective Studies
Radiotherapy Planning, Computer-Assisted
Registries
Young Adult
Research team
Clinic Acad RT Huddart
Clin Trials & Stats Unit
Targeted Therapy
Radiother Phys Modelling
Language
eng
Date accepted
2021-07-02
License start date
2021-11-15
Citation
International Journal of Radiation: Oncology - Biology - Physics, 2021, 111 (4), pp. 867 - 875
Publisher
ELSEVIER SCIENCE INC