Frontiers in Oncology (Feb 2024)
Dosimetric benefit of online treatment plan adaptation in stereotactic ultrahypofractionated MR-guided radiotherapy for localized prostate cancer
- Christoph A. Fink,
- Christoph A. Fink,
- Christoph A. Fink,
- Carolin Buchele,
- Carolin Buchele,
- Carolin Buchele,
- Lukas Baumann,
- Jakob Liermann,
- Jakob Liermann,
- Jakob Liermann,
- Philipp Hoegen,
- Philipp Hoegen,
- Philipp Hoegen,
- Philipp Hoegen,
- Jonas Ristau,
- Jonas Ristau,
- Jonas Ristau,
- Sebastian Regnery,
- Sebastian Regnery,
- Sebastian Regnery,
- Elisabetta Sandrini,
- Elisabetta Sandrini,
- Elisabetta Sandrini,
- Laila König,
- Laila König,
- Laila König,
- Carolin Rippke,
- Carolin Rippke,
- Carolin Rippke,
- David Bonekamp,
- David Bonekamp,
- David Bonekamp,
- Heinz-Peter Schlemmer,
- Juergen Debus,
- Juergen Debus,
- Juergen Debus,
- Juergen Debus,
- Juergen Debus,
- Juergen Debus,
- Stefan A. Koerber,
- Stefan A. Koerber,
- Stefan A. Koerber,
- Stefan A. Koerber,
- Sebastian Klüter,
- Sebastian Klüter,
- Sebastian Klüter,
- Juliane Hörner-Rieber,
- Juliane Hörner-Rieber,
- Juliane Hörner-Rieber,
- Juliane Hörner-Rieber
Affiliations
- Christoph A. Fink
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Christoph A. Fink
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Christoph A. Fink
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Carolin Buchele
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Carolin Buchele
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Carolin Buchele
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Lukas Baumann
- Institute of Medical Biometry (IMBI), University of Heidelberg, Heidelberg, Germany
- Jakob Liermann
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Jakob Liermann
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Jakob Liermann
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Philipp Hoegen
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Philipp Hoegen
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Philipp Hoegen
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Philipp Hoegen
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Jonas Ristau
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Jonas Ristau
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Jonas Ristau
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Sebastian Regnery
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Sebastian Regnery
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Sebastian Regnery
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Elisabetta Sandrini
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Elisabetta Sandrini
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Elisabetta Sandrini
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Laila König
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Laila König
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Laila König
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Carolin Rippke
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Carolin Rippke
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Carolin Rippke
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- David Bonekamp
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- David Bonekamp
- Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- David Bonekamp
- German Cancer Consortium (DKTK), Partner Side Heidelberg, Heidelberg, Germany
- Heinz-Peter Schlemmer
- Division of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Juergen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Juergen Debus
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Juergen Debus
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Juergen Debus
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Juergen Debus
- German Cancer Consortium (DKTK), Partner Side Heidelberg, Heidelberg, Germany
- Juergen Debus
- Heidelberg Ion-Beam Therapy Center (HIT), Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Stefan A. Koerber
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Stefan A. Koerber
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Stefan A. Koerber
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Stefan A. Koerber
- Department of Radiation Oncology, Barmherzige Brueder Hospital Regensburg, Regensburg, Germany
- Sebastian Klüter
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Sebastian Klüter
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Sebastian Klüter
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Juliane Hörner-Rieber
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
- Juliane Hörner-Rieber
- Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany
- Juliane Hörner-Rieber
- National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Juliane Hörner-Rieber
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- DOI
- https://doi.org/10.3389/fonc.2024.1308406
- Journal volume & issue
-
Vol. 14
Abstract
BackgroundApart from superior soft tissue contrast, MR-guided stereotactic body radiation therapy (SBRT) offers the chance for daily online plan adaptation. This study reports on the comparison of dose parameters before and after online plan adaptation in MR-guided SBRT of localized prostate cancer.Materials and methods32 consecutive patients treated with ultrahypofractionated SBRT for localized prostate cancer within the prospective SMILE trial underwent a planning process for MR-guided radiotherapy with 37.5 Gy applied in 5 fractions. A base plan, derived from MRI simulation at an MRIdian Linac, was registered to daily MRI scans (predicted plan). Following target and OAR recontouring, the plan was reoptimized based on the daily anatomy (adapted plan). CTV and PTV coverage and doses at OAR were compared between predicted and adapted plans using linear mixed regression models.ResultsIn 152 out of 160 fractions (95%), an adapted radiation plan was delivered. Mean CTV and PTV coverage increased by 1.4% and 4.5% after adaptation. 18% vs. 95% of the plans had a PTV coverage ≥95% before and after online adaptation, respectively. 78% vs. 100% of the plans had a CTV coverage ≥98% before and after online adaptation, respectively. The D0.2cc for both bladder and rectum were <38.5 Gy in 93% vs. 100% before and after online adaptation. The constraint at the urethra with a dose of <37.5 Gy was achieved in 59% vs. 93% before and after online adaptation.ConclusionOnline adaptive plan adaptation improves target volume coverage and reduces doses to OAR in MR-guided SBRT of localized prostate cancer. Online plan adaptation could potentially further reduce acute and long-term side effects and improve local failure rates in MR-guided SBRT of localized prostate cancer.
Keywords
- stereotactic body radiation therapy
- MR-guided radiotherapy
- daily adaptive radiotherapy
- prostate cancer
- dosimetric benefits
