UNASSIGNED: Clinical and dosimetric data of patients treated with MRgSBRT on a 0.35 T MR-Linac at 11 institutions between 2016 and 2022 were analyzed. Local control (LC), local progression-free survival (LPFS), distant progression-free survival (DPFS) and overall survival (OS) were estimated using Kaplan-Meier method and log-rank test.
UNASSIGNED: A total of 255 patients (269 adrenal metastases) were included. Metastatic pattern was solitary in 25.9 % and oligometastatic in 58.0 % of patients. Median total dose was 45 Gy (range, 16-60 Gy) in a median of 5 fractions, and the median BED10 was 100 Gy (range, 37.5-132.0 Gy). Adaptation was done in 87.4 % of delivered fractions based on the individual clinicians\' judgement. The 1- and 2- year LPFS rates were 94.0 % (95 % CI: 90.7-97.3 %) and 88.3 % (95 % CI: 82.4-94.2 %), respectively and only 2 patients (0.8 %) experienced grade 3 + toxicity. No local recurrences were observed after treatment to a total dose of BED10 > 100 Gy, with single fraction or fractional dose of > 10 Gy.
UNASSIGNED: This is a large retrospective multi-institutional study to evaluate the treatment outcomes and toxicities with MRgSBRT in over 250 patients, demonstrating the need for frequent adaptation in 87.4 % of delivered fractions to achieve a 1- year LPFS rate of 94 % and less than 1 % rate of grade 3 + toxicity. Outcomes analysis in 269 adrenal lesions revealed improved outcomes with delivery of a BED10 > 100 Gy, use of single fraction SBRT and with fraction doses > 10 Gy, providing benchmarks for future clinical trials.
■分析了2016年至2022年在11个机构的0.35TMR-Linac上接受MRgSBRT治疗的患者的临床和剂量学数据。本地控制(LC),局部无进展生存期(LPFS),采用Kaplan-Meier法和log-rank检验估计远端无进展生存期(DPFS)和总生存期(OS).
■共纳入255例患者(269例肾上腺转移)。25.9%的患者为单发转移,58.0%的患者为寡转移。中位总剂量为45Gy(范围,16-60Gy),中位数为5个分数,BED10的中位数为100Gy(范围,37.5-132.0Gy)。根据个别临床医生的判断,87.4%的交付部分进行了适应。1年和2年LPFS率分别为94.0%(95%CI:90.7-97.3%)和88.3%(95%CI:82.4-94.2%),分别和只有2例患者(0.8%)出现3级+毒性.治疗总剂量为BED10>100Gy后未观察到局部复发,单部分或部分剂量>10Gy。
这是一项大型回顾性多机构研究,旨在评估250多名患者使用MRgSBRT的治疗结果和毒性,证明需要在87.4%的递送部分中频繁适应,以实现94%的1年LPFS率和低于1%的3级毒性率。269个肾上腺病变的结果分析显示,BED10>100Gy的结果改善,使用单部分SBRT和部分剂量>10Gy,为未来的临床试验提供基准。