Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
Department of Radiation Oncology, University of Kansas School of Medicine, 3901 Rainbow Blvd, MS 4033, Kansas City, KS, 66160, USA.
Clin Transl Oncol. 2018 Feb;20(2):160-168. doi: 10.1007/s12094-017-1704-4. Epub 2017 Jun 13.
To report a single-institutional experience with the use of magnetic resonance imaging (MRI)-guided radiotherapy for cancers of the head and neck.
Between October 2014 and October 2016, 18 patients with newly diagnosed cancers of the head and neck were prospectively enrolled on an institutional registry trial investigating the feasibility and efficacy of external-beam radiotherapy delivered using on-board MRI. All patients had biopsy-proven evidence of malignancy, measurable disease, and the ability to provide consent. None had previously received any treatment. Median dose was 70 Gy (range 54-70 Gy). MRI scans were obtained as part of an image-guided registration protocol for alignment prior to and during each treatment. Concurrent chemotherapy was administered to 14 patients (78%). Patient-reported outcomes were assessed using the University of Washington quality of life instrument.
Seventeen of 18 patients completed the planned intensity-modulated radiotherapy (IMRT) treatment of which 15 (83%) had a complete response and 2 (11%) had a partial response based on initial post-therapy positron emission tomography (PET) at 3 months. The 1-year estimates of progression-free survival, overall survival, and local-regional control were 95, 96, and 95%, respectively. There were no treatment-related fatalities. The incidence of grade 3+ acute toxicity was 44%. The proportion of patients rating their health-related quality of life as "very good" or "outstanding" at 6 months and 1 year after completion of radiation therapy was 60 and 70%, respectively.
MRI-guided radiotherapy achieves clinical outcomes comparable to contemporary series reporting on IMRT for head and neck cancer.
报告一家机构使用磁共振成像（MRI）引导放疗治疗头颈部癌症的经验。
2014 年 10 月至 2016 年 10 月期间，18 例新诊断的头颈部癌症患者前瞻性纳入了一项机构注册研究，该研究旨在调查使用机载 MRI 进行外照射放疗的可行性和疗效。所有患者均经活检证实有恶性肿瘤、可测量的疾病，并能提供同意。他们均未接受过任何治疗。中位剂量为 70 Gy（范围 54-70 Gy）。MRI 扫描作为图像引导注册协议的一部分，用于在每次治疗前后进行对准。14 例患者（78%）接受了同期化疗。采用华盛顿大学生活质量量表评估患者报告的结果。
18 例患者中有 17 例完成了计划的调强放疗（IMRT），其中 15 例（83%）根据 3 个月时初始治疗后正电子发射断层扫描（PET）完全缓解，2 例（11%）部分缓解。1 年无进展生存率、总生存率和局部区域控制率分别为 95%、96%和 95%。无治疗相关死亡。3+ 级急性毒性发生率为 44%。6 个月和 1 年完成放疗后，分别有 60%和 70%的患者将其健康相关生活质量评为“非常好”或“出色”。
MRI 引导放疗对头颈部癌症的临床结果与报告 IMRT 的当代系列结果相当。
