PDF(Pubmed)
Abstract：
(1) Background: Recent publications foster stereotactic body radiotherapy (SBRT) in patients with adrenal oligometastases or oligoprogression. However, local control (LC) after non-adaptive SBRT shows the potential for improvement. Online adaptive MR-guided SBRT (MRgSBRT) improves tumor coverage and organ-at-risk (OAR) sparing. Long-term results of adaptive MRgSBRT are still sparse. (2) Methods: Adaptive MRgSBRT was performed on a 0.35 T MR-Linac. LC, overall survival (OS), progression-free survival (PFS), overall response rate (ORR), and toxicity were assessed. (3) Results: 35 patients with 40 adrenal metastases were analyzed. The median gross tumor volume was 30.6 cc. The most common regimen was 10 fractions at 5 Gy. The median biologically effective dose (BED10) was 75.0 Gy. Plan adaptation was performed in 98% of all fractions. The median follow-up was 7.9 months. One local failure occurred after 16.6 months, resulting in estimated LC rates of 100% at one year and 90% at two years. ORR was 67.5%. The median OS was 22.4 months, and the median PFS was 5.1 months. No toxicity > CTCAE grade 2 occurred. (4) Conclusions: LC and ORR after adrenal adaptive MRgSBRT were excellent, even in a cohort with comparably large metastases. A BED10 of 75 Gy seems sufficient for improved LC in comparison to non-adaptive SBRT.
摘要：
（1）背景：最近的出版物促进了肾上腺寡转移或寡进展患者的立体定向放射治疗（SBRT）。然而,非自适应SBRT后的局部控制(LC)显示出改进的潜力。在线自适应MR引导的SBRT（MRgSBRT）改善了肿瘤覆盖率和危险器官（OAR）。自适应MRgSBRT的长期结果仍然是稀疏的。（2）方法：在0.35TMR-Linac上进行自适应MRgSBRT。LC,总生存期（OS），无进展生存期（PFS），总反应率（ORR），和毒性进行了评估。(3)结果:对35例肾上腺转移瘤患者40例进行分析。中位总肿瘤体积为30.6cc。最常见的方案是5Gy的10个分数。中位生物有效剂量(BED10)为75.0Gy。计划适应在所有部分的98%中进行。中位随访时间为7.9个月。16.6个月后发生一次局部故障，估计一年的LC率为100%，两年为90%。ORR为67.5%。中位OS为22.4个月,中位PFS为5.1个月.无毒性>CTCAE2级发生。(4)结论:肾上腺适应性MRgSBRT术后LC和ORR均较好,即使在具有相当大的转移的队列中。与非适应性SBRT相比，75Gy的BED10似乎足以改善LC。
