Faculty Collaboration Database

MRI guided stereotactic radiotherapy for locally advanced pancreatic cancer. Br J Radiol 2018 Nov;91(1091):20170563

Date

08/01/2018

Pubmed ID

30063383

Pubmed Central ID

PMC6475956

DOI

10.1259/bjr.20170563

Scopus ID

2-s2.0-85055211788 (requires institutional sign-in at Scopus site)   32 Citations

Abstract

OBJECTIVE:: We want to explore the safety and technical feasibility of MRI-guided stereotactic radiotherapy for locally advanced pancreatic cancer.

METHODS:: A custom-made abdominal corset was manufactured to reduce breathing induced tumour motion. Delineation of the tumour and organs at risk (OARs) was performed on CT and multiparametric MRI. Tumour motion was quantified with cine MRI. After treatment planning, the static dose distribution was convolved with the cine MRI-based motion trajectory to simulate the delivered dose to the tumour and OARs. Stereotactic body radiation therapy (SBRT) was carried out up to a dose of 24 G in three fractions in 1 week.

RESULTS:: From July 2013 to January 2016, 20 patients were included. Tumours and OARs were clearly visible with contrast-enhanced CT and MRI. After simulation of the delivered dose taking the motion into account, an adequate target coverage was achieved with acceptable dose in the OARs. No Grade3 or higher treatment related toxicity was observed.

CONCLUSION:: MRI-guided SBRT for pancreatic cancer is technical feasible and safe, with no treatment related grade ≥3 toxicity. New strategies are applied, including an individual corset to reduce breathing motion, MRI-based delineation and simulation of motion-integrated dose distributions.

ADVANCES IN KNOWLEDGE:: This article is the first to describe an MRI-integrated workflow in SBRT for locally advanced pancreatic cancer. In addition, it demonstrated that SBRT with an abdominal corset to reduce tumour motion is feasible and safe.

TRIAL REGISTRATION:: This trial was registered at www.clinicaltrials.gov (NCT01898741) on July 9, 2013.

Author List

Heerkens HD, van Vulpen M, Erickson B, Reerink O, Intven MP, van den Berg CA, Molenaar IQ, Vleggaar FP, Meijer GJ

Author

Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Clothing
Feasibility Studies
Female
Fiducial Markers
Humans
Magnetic Resonance Imaging, Cine
Magnetic Resonance Imaging, Interventional
Male
Middle Aged
Movement
Multimodal Imaging
Pancreatic Neoplasms
Prospective Studies
Quality of Life
Radiometry
Radiosurgery
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Surgery, Computer-Assisted
Tomography, X-Ray Computed
Treatment Outcome