PDF(Pubmed)
Abstract：
UNASSIGNED: Our institution was the first in the world to clinically implement MR-guided adaptive radiotherapy (MRgART) in 2014. In 2021, we installed a CT-guided adaptive radiotherapy (CTgART) unit, becoming one of the first clinics in the world to build a dual-modality ART clinic. Herein we review factors that lead to the development of a high-volume dual-modality ART program and treatment census over an initial, one-year period.
UNASSIGNED: The clinical adaptive service at our institution is enabled with both MRgART (MRIdian, ViewRay, Inc, Mountain View, CA) and CTgART (ETHOS, Varian Medical Systems, Palo Alto, CA) platforms. We analyzed patient and treatment information including disease sites treated, radiation dose and fractionation, and treatment times for patients on these two platforms. Additionally, we reviewed our institutional workflow for creating, verifying, and implementing a new adaptive workflow on either platform.
UNASSIGNED: From October 2021 to September 2022, 256 patients were treated with adaptive intent at our institution, 186 with MRgART and 70 with CTgART. The majority (106/186) of patients treated with MRgART had pancreatic cancer, and the most common sites treated with CTgART were pelvis (23/70) and abdomen (20/70). 93.0% of treatments on the MRgART platform were stereotactic body radiotherapy (SBRT), whereas only 72.9% of treatments on the CTgART platform were SBRT. Abdominal gated cases were allotted a longer time on the CTgART platform compared to the MRgART platform, whereas pelvic cases were allotted a shorter time on the CTgART platform when compared to the MRgART platform. Our adaptive implementation technique has led to six open clinical trials using MRgART and seven using CTgART.
UNASSIGNED: We demonstrate the successful development of a dual platform ART program in our clinic. Ongoing efforts are needed to continue the development and integration of ART across platforms and disease sites to maximize access and evidence for this technique worldwide.
UNASSIGNED: The clinical adaptive service at our institution is enabled with both MRgART (MRIdian, ViewRay, Inc, Mountain View, CA) and CTgART (ETHOS, Varian Medical Systems, Palo Alto, CA) platforms. We analyzed patient and treatment information including disease sites treated, radiation dose and fractionation, and treatment times for patients on these two platforms. Additionally, we reviewed our institutional workflow for creating, verifying, and implementing a new adaptive workflow on either platform.
UNASSIGNED: From October 2021 to September 2022, 256 patients were treated with adaptive intent at our institution, 186 with MRgART and 70 with CTgART. The majority (106/186) of patients treated with MRgART had pancreatic cancer, and the most common sites treated with CTgART were pelvis (23/70) and abdomen (20/70). 93.0% of treatments on the MRgART platform were stereotactic body radiotherapy (SBRT), whereas only 72.9% of treatments on the CTgART platform were SBRT. Abdominal gated cases were allotted a longer time on the CTgART platform compared to the MRgART platform, whereas pelvic cases were allotted a shorter time on the CTgART platform when compared to the MRgART platform. Our adaptive implementation technique has led to six open clinical trials using MRgART and seven using CTgART.
UNASSIGNED: We demonstrate the successful development of a dual platform ART program in our clinic. Ongoing efforts are needed to continue the development and integration of ART across platforms and disease sites to maximize access and evidence for this technique worldwide.
摘要：
■我们的机构是世界上第一个在2014年临床上实施MR引导自适应放射治疗（MRgART）的机构。2021年，我们安装了CT引导的自适应放射治疗（CTgART）装置，成为世界上首批建立双模态ART诊所的诊所之一。在这里，我们回顾了导致开发大量双模态ART计划和治疗普查的因素，一年期间。
■我们机构的临床适应性服务启用了两种MRgART(MRIdian，ViewRay,Inc,山景,CA）和CTgART（ETHOS，瓦里安医疗系统，帕洛阿尔托,CA)平台。我们分析了患者和治疗信息，包括治疗的疾病部位，辐射剂量和分割，以及这两个平台上患者的治疗时间。此外,我们审查了我们的机构工作流程，验证,并在任一平台上实现新的自适应工作流。
■从2021年10月到2022年9月，256名患者在我们的机构接受了适应性治疗。186与MRgART和70与CTgART。接受MRgART治疗的大多数患者（106/186）患有胰腺癌，CTgART治疗最常见的部位是骨盆(23/70)和腹部(20/70)。MRgART平台上93.0％的治疗是立体定向放疗（SBRT），而CTgART平台上仅72.9%的治疗是SBRT.与MRgART平台相比，在CTgART平台上为腹部门控病例分配了更长的时间。而与MRgART平台相比,盆腔病例在CTgART平台上的时间更短.我们的适应性实施技术已导致使用MRgART的6项开放临床试验和使用CTgART的7项开放临床试验。
■我们展示了在我们的临床中成功开发双平台ART程序。需要不断的努力，以继续跨平台和疾病站点的ART的开发和整合，以最大程度地获取和证据。
■我们机构的临床适应性服务启用了两种MRgART(MRIdian，ViewRay,Inc,山景,CA）和CTgART（ETHOS，瓦里安医疗系统，帕洛阿尔托,CA)平台。我们分析了患者和治疗信息，包括治疗的疾病部位，辐射剂量和分割，以及这两个平台上患者的治疗时间。此外,我们审查了我们的机构工作流程，验证,并在任一平台上实现新的自适应工作流。
■从2021年10月到2022年9月，256名患者在我们的机构接受了适应性治疗。186与MRgART和70与CTgART。接受MRgART治疗的大多数患者（106/186）患有胰腺癌，CTgART治疗最常见的部位是骨盆(23/70)和腹部(20/70)。MRgART平台上93.0％的治疗是立体定向放疗（SBRT），而CTgART平台上仅72.9%的治疗是SBRT.与MRgART平台相比，在CTgART平台上为腹部门控病例分配了更长的时间。而与MRgART平台相比,盆腔病例在CTgART平台上的时间更短.我们的适应性实施技术已导致使用MRgART的6项开放临床试验和使用CTgART的7项开放临床试验。
■我们展示了在我们的临床中成功开发双平台ART程序。需要不断的努力，以继续跨平台和疾病站点的ART的开发和整合，以最大程度地获取和证据。
