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dc.contributor.authorIngle, M
dc.contributor.authorWhite, I
dc.contributor.authorChick, J
dc.contributor.authorStankiewicz, H
dc.contributor.authorMitchell, A
dc.contributor.authorBarnes, H
dc.contributor.authorHerbert, T
dc.contributor.authorNill, S
dc.contributor.authorOelfke, U
dc.contributor.authorHuddart, R
dc.contributor.authorNg-Cheng-Hin, B
dc.contributor.authorHafeez, S
dc.contributor.authorLalondrelle, S
dc.contributor.authorDunlop, A
dc.contributor.authorBhide, S
dc.identifier.citationClinical Oncology, 2022, pp. S0936-6555(22)00492-7 -en_US
dc.description.abstractAIMS: Neoadjuvant chemoradiotherapy followed by surgery is the mainstay of treatment for patients with rectal cancer. Standard clinical target volume (CTV) to planning target volume (PTV) margins of 10 mm are used to accommodate inter- and intrafraction motion of target. Treating on magnetic resonance-integrated linear accelerators (MR-linacs) allows for online manual recontouring and adaptation (MRgART) enabling the reduction of PTV margins. The aim of this study was to investigate motion of the primary CTV (CTVA; gross tumour volume and macroscopic nodes with 10 mm expansion to cover microscopic disease) in order to develop a simultaneous integrated boost protocol for use on MR-linacs. MATERIALS AND METHODS: Patients suitable for neoadjuvant chemoradiotherapy were recruited for treatment on MR-linac using a two-phase technique; only the five phase 1 fractions on MR-linac were used for analysis. Intrafraction motion of CTVA was measured between pre-treatment and post-treatment MRI scans. In MRgART, isotropically expanded pre-treatment PTV margins from 1 to 10 mm were rigidly propagated to post-treatment MRI to determine overlap with 95% of CTVA. The PTV margin was considered acceptable if overlap was >95% in 90% of fractions. To understand the benefit of MRgART, the same methodology was repeated using a reference computed tomography planning scan for pre-treatment imaging. RESULTS: In total, nine patients were recruited between January 2018 and December 2020 with T3a-T4, N0-N2, M0 disease. Forty-five fractions were analysed in total. The median motion across all planes was 0 mm, demonstrating minimal intrafraction motion. A PTV margin of 3 and 5mm was found to be acceptable in 96 and 98% of fractions, respectively. When comparing to the computed tomography reference scan, the analysis found that PTV margins to 5 and 10 mm only acceptably covered 51 and 76% of fractions, respectively. CONCLUSION: PTV margins can be reduced to 3-5 mm in MRgART for rectal cancer treatment on MR-linac within an simultaneous integrated boost protocol.
dc.format.extentS0936-6555(22)00492-7 -
dc.publisherElsevier BVen_US
dc.relation.ispartofClinical Oncology
dc.subjectAdaptive radiotherapy
dc.subjectrectal cancer
dc.titleUnderstanding the Benefit of Magnetic Resonance-guided Adaptive Radiotherapy in Rectal Cancer Patients: a Single-centre Study.en_US
dc.typeJournal Article
rioxxterms.typeJournal Article/Reviewen_US
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer
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/Clinical Academic Radiotherapy (Huddart)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Gynaecological Cancer/Gynaecological Cancer (hon.)
pubs.organisational-group/ICR/Students/PhD and MPhil
pubs.organisational-group/ICR/Students/PhD and MPhil/19/20 Starting Cohort
pubs.publication-statusPublished online
icr.researchteamGynaecological Canceren_US
icr.researchteamRadiother Phys Modellingen_US
icr.researchteamClinic Acad RT Huddarten_US
dc.contributor.icrauthorIngle, Manasi
dc.contributor.icrauthorNill, Simeon
dc.contributor.icrauthorHuddart, Robert
dc.contributor.icrauthorHafeez, Shaista
dc.contributor.icrauthorLalondrelle, Susan
icr.provenanceDeposited by Mr Arek Surman on 2023-01-13. Deposit type is initial. No. of files: 1. Files: PIIS0936655522004927.pdf

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