Gonsalves Daniela, Ocanto Abrahams, Meilan Eduardo, Gomez Alberto, Dominguez Jesus, Torres Lisselott, Pascual Castalia Fernández, Teja Macarena, Linde Miguel Montijano, Guijarro Marcos, Rivas Daniel, Begara Jose, González Jose Antonio, Andreescu Jon, Holgado Esther, Alcaraz Diego, López Escarlata, Dzhugashvli Maia, Lopez-Campos Fernando, Alongi Filippo, Couñago Felipe
Department of Radiation Oncology, Hospital Universitario San Francisco de Asís, GenesisCare, 28002 Madrid, Spain.
Department of Radiation Oncology, Hospital Universitario Vithas La Milagrosa, GenesisCare, 28010 Madrid, Spain.
Cancers (Basel). 2024 Apr 26;16(9):1685. doi: 10.3390/cancers16091685.
This observational, descriptive, longitudinal, and prospective basket-type study (Registry #5289) prospectively evaluated the feasibility and acute toxicity of hypo-fractionated radiotherapy on the first 0.35T MR-LINAC in Spain. A total of 37 patients were included between August and December 2023, primarily with prostate tumors (59.46%), followed by pancreatic tumors (32.44%). Treatment regimens typically involved extreme hypo-fractionated radiotherapy, with precise dose delivery verified through quality assurance measures. Acute toxicity assessment at treatment completion revealed manageable cystitis, with one case persisting at the three-month follow-up. Gastrointestinal toxicity was minimal. For pancreatic tumors, daily adaptation of organ-at-risk (OAR) and gross tumor volume (GTV) was practiced, with median doses to OAR within acceptable limits. Three patients experienced gastrointestinal toxicity, mainly nausea. Overall, the study demonstrates the feasibility and safety of extreme hypo-fractionated radiotherapy on a 0.35T MR-LINAC, especially for challenging anatomical sites like prostate and pancreatic tumors. These findings support the feasibility of MR-LINAC-based radiotherapy in delivering precise treatments with minimal toxicity, highlighting its potential for optimizing cancer treatment strategies.
这项观察性、描述性、纵向和前瞻性的篮子型研究（注册号5289）前瞻性地评估了西班牙首台0.35T MR-LINAC上进行的大分割放疗的可行性和急性毒性。2023年8月至12月共纳入37例患者，主要为前列腺肿瘤患者（59.46%），其次是胰腺肿瘤患者（32.44%）。治疗方案通常包括超分割放疗，并通过质量保证措施验证精确的剂量输送。治疗结束时的急性毒性评估显示膀胱炎可控制，1例在三个月随访时仍持续存在。胃肠道毒性极小。对于胰腺肿瘤，每天对危及器官（OAR）和大体肿瘤体积（GTV）进行调整，OAR的中位剂量在可接受范围内。3例患者出现胃肠道毒性，主要为恶心。总体而言，该研究证明了在0.35T MR-LINAC上进行超分割放疗的可行性和安全性，特别是对于前列腺和胰腺肿瘤等具有挑战性的解剖部位。这些发现支持了基于MR-LINAC的放疗在以最小毒性提供精确治疗方面的可行性，突出了其优化癌症治疗策略的潜力。
