Barnes Helen, Alexander Sophie, Bhide Shreerang, Dunlop Alex, Gupta Amit, Harrington Kevin, Herbert Trina, Wong Kee Howe, McNair Helen
Royal Marsden NHS Foundation Trust, United Kingdom.
Institute of Cancer Research, United Kingdom.
Tech Innov Patient Support Radiat Oncol. 2025 Jul 21;35:100324. doi: 10.1016/j.tipsro.2025.100324. eCollection 2025 Sep.
Head and neck cancer (HNC) treatment on the Unity MR-Linac (MRL) (Elekta AB, Stockholm, Sweden) has been developed using the novel adapt-to-shape Lite (ATS-lite) method to create clinically acceptable adaptive treatments clinician-free. Here we investigate patient experience and acceptability of this technique.
Ten HNC patients treated to 65 Gy in 30 fractions with MRI-guided adaptive radiotherapy (MRIgART) within the PERMIT trial (NCT03727698), were included. Data collected comprised patient demographics, treatment time, and patient experience, using an established MRL questionnaire.Back-up plans were created for use on the conventional linac with CT guidance, to prevent missed fractions. The frequency of use was collected and categorised to reflect the cause.
The median total treatment time for ATS-lite method was 39 min. The percentage of treatments under 60 mins was 98.8 %.Questionnaire response rate was 85% and individual question response rate was 99%. Ninety-six percent of responses scored 2 or 3 on the Likert scale, a positive answer. The lowest scoring question was "I forced myself to manage the situation," with a mean (SD) of 2.4 (0.9).The MRL delivered 84.7 % of treatments. The back-up plan was used for 46 fractions, 7 attributed to patient tolerance (n = 2 patients).
Average treatment times for the ATS-lite HNC MRIgART are acceptable and faster than reported ATP treatment times. Patient-reported experience was extremely positive. Use of back-up plans attributable to lack of patient tolerance was low. This technique can used with the confidence that patient experience is not negatively impacted.
使用新型适应形状精简版（ATS-lite）方法，在Unity MR直线加速器（MRL）（瑞典斯德哥尔摩的医科达公司）上开展头颈部癌（HNC）治疗，以实现临床可接受的无临床医生参与的自适应治疗。在此，我们调查了患者对该技术的体验和可接受性。
纳入了10名头颈部癌患者，这些患者在PERMIT试验（NCT03727698）中接受了MRI引导的自适应放疗（MRIgART），分30次给予65 Gy照射剂量。收集的数据包括患者人口统计学信息、治疗时间和患者体验（使用既定的MRL问卷）。制定了备用计划以便在传统直线加速器的CT引导下使用以防止漏照剂量。收集并分类使用频率以反映原因。
ATS-lite方法的中位总治疗时间为39分钟。60分钟以内完成治疗的比例为98.8%。问卷回复率为85%，单个问题回复率为99%。96%的回复在李克特量表上得分为2或3，为肯定回答。得分最低的问题是“我强迫自己应对这种情况”，平均（标准差）为2.4（0.9）。MRL完成了84.7%的治疗。备用计划使用了46次剂量，其中7次归因于患者耐受性（2名患者）。
ATS-lite头颈部癌MRIgART的平均治疗时间是可接受的，并且比报道的ATP治疗时间更快。患者报告的体验非常积极。因患者耐受性不足而使用备用计划的情况较少。可以放心使用该技术，因为患者体验不会受到负面影响。
