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The benefit of MR‐only radiotherapy treatment planning for anal and rectal cancers: A planning study

INTRODUCTION: Limited evidence exists showing the benefit of magnetic resonance (MR)‐only radiotherapy treatment planning for anal and rectal cancers. This study aims to assess the impact of MR‐only planning on target volumes (TVs) and treatment plan doses to organs at risks (OARs) for anal and rect...

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Autores principales: Bird, David, Nix, Michael G., McCallum, Hazel, Teo, Mark, Gilbert, Alexandra, Casanova, Nathalie, Cooper, Rachel, Buckley, David L., Sebag‐Montefiore, David, Speight, Richard, Al‐Qaisieh, Bashar, Henry, Ann M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8598134/
https://www.ncbi.nlm.nih.gov/pubmed/34687138
http://dx.doi.org/10.1002/acm2.13423
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author Bird, David
Nix, Michael G.
McCallum, Hazel
Teo, Mark
Gilbert, Alexandra
Casanova, Nathalie
Cooper, Rachel
Buckley, David L.
Sebag‐Montefiore, David
Speight, Richard
Al‐Qaisieh, Bashar
Henry, Ann M.
author_facet Bird, David
Nix, Michael G.
McCallum, Hazel
Teo, Mark
Gilbert, Alexandra
Casanova, Nathalie
Cooper, Rachel
Buckley, David L.
Sebag‐Montefiore, David
Speight, Richard
Al‐Qaisieh, Bashar
Henry, Ann M.
author_sort Bird, David
collection PubMed
description INTRODUCTION: Limited evidence exists showing the benefit of magnetic resonance (MR)‐only radiotherapy treatment planning for anal and rectal cancers. This study aims to assess the impact of MR‐only planning on target volumes (TVs) and treatment plan doses to organs at risks (OARs) for anal and rectal cancers versus a computed tomography (CT)‐only pathway. MATERIALS AND METHODS: Forty‐six patients (29 rectum and 17 anus) undergoing preoperative or radical external beam radiotherapy received CT and T2 MR simulation. TV and OARs were delineated on CT and MR, and volumetric arc therapy treatment plans were optimized independently (53.2 Gy/28 fractions for anus, 45 Gy/25 fractions for rectum). Further treatment plans assessed gross tumor volume (GTV) dose escalation. Differences in TV volumes and OAR doses, in terms of Vx Gy (organ volume (%) receiving x dose (Gy)), were assessed. RESULTS: MR GTV and primary planning TV (PTV) volumes systematically reduced by 13 cc and 98 cc (anus) and 44 cc and 109 cc (rectum) respectively compared to CT volumes. Statistically significant OAR dose reductions versus CT were found for bladder and uterus (rectum) and bladder, penile bulb, and genitalia (anus). With GTV boosting, statistically significant dose reductions were found for sigmoid, small bowel, vagina, and penile bulb (rectum) and vagina (anus). CONCLUSION: Our findings provide evidence that the introduction of MR (whether through MR‐only or CT‐MR pathways) to radiotherapy treatment planning for anal and rectal cancers has the potential to improve treatments. MR‐related OAR dose reductions may translate into less treatment‐related toxicity for patients or greater ability to dose escalate.
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spelling pubmed-85981342021-12-02 The benefit of MR‐only radiotherapy treatment planning for anal and rectal cancers: A planning study Bird, David Nix, Michael G. McCallum, Hazel Teo, Mark Gilbert, Alexandra Casanova, Nathalie Cooper, Rachel Buckley, David L. Sebag‐Montefiore, David Speight, Richard Al‐Qaisieh, Bashar Henry, Ann M. J Appl Clin Med Phys Radiation Oncology Physics INTRODUCTION: Limited evidence exists showing the benefit of magnetic resonance (MR)‐only radiotherapy treatment planning for anal and rectal cancers. This study aims to assess the impact of MR‐only planning on target volumes (TVs) and treatment plan doses to organs at risks (OARs) for anal and rectal cancers versus a computed tomography (CT)‐only pathway. MATERIALS AND METHODS: Forty‐six patients (29 rectum and 17 anus) undergoing preoperative or radical external beam radiotherapy received CT and T2 MR simulation. TV and OARs were delineated on CT and MR, and volumetric arc therapy treatment plans were optimized independently (53.2 Gy/28 fractions for anus, 45 Gy/25 fractions for rectum). Further treatment plans assessed gross tumor volume (GTV) dose escalation. Differences in TV volumes and OAR doses, in terms of Vx Gy (organ volume (%) receiving x dose (Gy)), were assessed. RESULTS: MR GTV and primary planning TV (PTV) volumes systematically reduced by 13 cc and 98 cc (anus) and 44 cc and 109 cc (rectum) respectively compared to CT volumes. Statistically significant OAR dose reductions versus CT were found for bladder and uterus (rectum) and bladder, penile bulb, and genitalia (anus). With GTV boosting, statistically significant dose reductions were found for sigmoid, small bowel, vagina, and penile bulb (rectum) and vagina (anus). CONCLUSION: Our findings provide evidence that the introduction of MR (whether through MR‐only or CT‐MR pathways) to radiotherapy treatment planning for anal and rectal cancers has the potential to improve treatments. MR‐related OAR dose reductions may translate into less treatment‐related toxicity for patients or greater ability to dose escalate. John Wiley and Sons Inc. 2021-10-22 /pmc/articles/PMC8598134/ /pubmed/34687138 http://dx.doi.org/10.1002/acm2.13423 Text en © 2021 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Radiation Oncology Physics
Bird, David
Nix, Michael G.
McCallum, Hazel
Teo, Mark
Gilbert, Alexandra
Casanova, Nathalie
Cooper, Rachel
Buckley, David L.
Sebag‐Montefiore, David
Speight, Richard
Al‐Qaisieh, Bashar
Henry, Ann M.
The benefit of MR‐only radiotherapy treatment planning for anal and rectal cancers: A planning study
title The benefit of MR‐only radiotherapy treatment planning for anal and rectal cancers: A planning study
title_full The benefit of MR‐only radiotherapy treatment planning for anal and rectal cancers: A planning study
title_fullStr The benefit of MR‐only radiotherapy treatment planning for anal and rectal cancers: A planning study
title_full_unstemmed The benefit of MR‐only radiotherapy treatment planning for anal and rectal cancers: A planning study
title_short The benefit of MR‐only radiotherapy treatment planning for anal and rectal cancers: A planning study
title_sort benefit of mr‐only radiotherapy treatment planning for anal and rectal cancers: a planning study
topic Radiation Oncology Physics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8598134/
https://www.ncbi.nlm.nih.gov/pubmed/34687138
http://dx.doi.org/10.1002/acm2.13423
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