1. MR-guided stereotactic radiotherapy of infra-diaphragmatic oligometastases: Evaluation of toxicity and dosimetric parameters.
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van Overeem Felter, Mette, Møller, Pia Krause, Josipovic, Mirjana, Bekke, Susanne Nørring, Bernchou, Uffe, Serup-Hansen, Eva, Madsen, Kasper, Parikh, Parag J., Kim, Joshua, Geertsen, Poul, Behrens, Claus P., Vogelius, Ivan R., Pøhl, Mette, Schytte, Tine, and Persson, Gitte Fredberg
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STEREOTACTIC radiotherapy , *TOXICITY testing , *MEDICAL dosimetry , *ADRENAL glands , *MAGNETIC resonance - Abstract
• MR-guided SABR was applied to 121 patients with abdominal soft tissue metastases. • Half of all targets were within 10 mm of a radiosensitive OAR. • The incidence of ≥ grade 3 treatment-related toxicity was 3.5 %. • GI OAR D 0.1cc , D 1cc , and D 20cc were associated with grade ≥ 2 GI toxicity. • We provide a multivariable NTCP model for GI OAR D 0.1cc and PS. The SOFT trial is a prospective, multicenter, phase 2 trial investigating magnetic resonance (MR)-guided stereotactic ablative radiotherapy (SABR) for abdominal, soft tissue metastases in patients with oligometastatic disease (OMD) (clinicaltrials.gov ID NCT04407897). We present the primary endpoint analysis of 1-year treatment-related toxicity (TRAE). Patients with up to five oligometastases from non-hematological cancers were eligible for inclusion. A risk-adapted strategy prioritized fixed organs at risk (OAR) constraints over target coverage. Fractionation schemes were 45–67.5 Gy in 3–8 fractions. The primary endpoint was grade ≥ 4 TRAE within 12 months post-SABR. The association between the risk of gastrointestinal (GI) toxicity and clinical and dosimetric parameters was tested using a normal tissue complication probability model. We included 121 patients with 147 oligometastatic targets, mainly located in the liver (41 %), lymph nodes (35 %), or adrenal glands (14 %). Nearly half of all targets (48 %, n = 71) were within 10 mm of a radiosensitive OAR. No grade 4 or 5 TRAEs, 3.5 % grade 3 TRAEs, and 43.7 % grade 2 TRAEs were reported within the first year of follow-up. We found a significant association between grade ≥ 2 GI toxicity and the parameters GI OAR D 0.1cc, D 1cc, and D 20cc. In this phase II study of MR-guided SABR of oligometastases in the infra-diaphragmatic region, we found a low incidence of toxicity despite half of the lesions being within 10 mm of a radiosensitive OAR. GI OAR D 0.1cc, D 1cc, and D 20cc were associated with grade ≥ 2 GI toxicity. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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