TY - JOUR
T1 - Patterns of Care, Tolerability, and Safety of the First Cohort of Patients Treated on a Novel High-Field MR-Linac Within the MOMENTUM Study
T2 - Initial Results From a Prospective Multi-Institutional Registry
AU - MR-Linac consortium
AU - de Mol van Otterloo, Sophie R.
AU - Christodouleas, John P.
AU - Blezer, Erwin L.A.
AU - Akhiat, Hafid
AU - Brown, Kevin
AU - Choudhury, Ananya
AU - Eggert, Dave
AU - Erickson, Beth A.
AU - Daamen, Lois A.
AU - Faivre-Finn, Corinne
AU - Fuller, Clifton D.
AU - Goldwein, Joel
AU - Hafeez, Shaista
AU - Hall, Emma
AU - Harrington, Kevin J.
AU - van der Heide, Uulke A.
AU - Huddart, Robert A.
AU - Intven, Martijn P.W.
AU - Kirby, Anna M.
AU - Lalondrelle, Susan
AU - McCann, Claire
AU - Minsky, Bruce D.
AU - Mook, Stella
AU - Nowee, Marlies E.
AU - Oelfke, Uwe
AU - Orrling, Kristina
AU - Philippens, Marielle E.P.
AU - Sahgal, Arjun
AU - Schultz, Christopher J.
AU - Tersteeg, Robbert J.H.A.
AU - Tijssen, Rob H.N.
AU - Tree, Alison C.
AU - van Triest, Baukelien
AU - Tseng, Chia Lin
AU - Hall, William A.
AU - Verkooijen, Helena M.
N1 - Publisher Copyright:
© 2021
PY - 2021/11/15
Y1 - 2021/11/15
N2 - Purpose: High-field magnetic resonance-linear accelerators (MR-Linacs), linear accelerators combined with a diagnostic magnetic resonance imaging (MRI) scanner and online adaptive workflow, potentially give rise to novel online anatomic and response adaptive radiation therapy paradigms. The first high-field (1.5T) MR-Linac received regulatory approval in late 2018, and little is known about clinical use, patient tolerability of daily high-field MRI, and toxicity of treatments. Herein we report the initial experience within the MOMENTUM Study (NCT04075305), a prospective international registry of the MR-Linac Consortium. Methods and Materials: Patients were included between February 2019 and October 2020 at 7 institutions in 4 countries. We used descriptive statistics to describe the patterns of care, tolerability (the percentage of patients discontinuing their course early), and safety (grade 3-5 Common Terminology Criteria for Adverse Events v.5 acute toxicity within 3 months after the end of treatment). Results: A total 943 patients participated in the MOMENTUM Study, 702 of whom had complete baseline data at the time of this analysis. Patients were primarily male (79%) with a median age of 68 years (range, 22-93) and were treated for 39 different indications. The most frequent indications were prostate (40%), oligometastatic lymph node (17%), brain (12%), and rectal (10%) cancers. The median number of fractions was 5 (range, 1-35). Six patients discontinued MR-Linac treatments, but none due to an inability to tolerate repeated high-field MRI. Of the 415 patients with complete data on acute toxicity at 3-month follow-up, 18 (4%) patients experienced grade 3 acute toxicity related to radiation. No grade 4 or 5 acute toxicity related to radiation was observed. Conclusions: In the first 21 months of our study, patterns of care were diverse with respect to clinical utilization, body sites, and radiation prescriptions. No patient discontinued treatment due to inability to tolerate daily high-field MRI scans, and the acute radiation toxicity experience was encouraging.
AB - Purpose: High-field magnetic resonance-linear accelerators (MR-Linacs), linear accelerators combined with a diagnostic magnetic resonance imaging (MRI) scanner and online adaptive workflow, potentially give rise to novel online anatomic and response adaptive radiation therapy paradigms. The first high-field (1.5T) MR-Linac received regulatory approval in late 2018, and little is known about clinical use, patient tolerability of daily high-field MRI, and toxicity of treatments. Herein we report the initial experience within the MOMENTUM Study (NCT04075305), a prospective international registry of the MR-Linac Consortium. Methods and Materials: Patients were included between February 2019 and October 2020 at 7 institutions in 4 countries. We used descriptive statistics to describe the patterns of care, tolerability (the percentage of patients discontinuing their course early), and safety (grade 3-5 Common Terminology Criteria for Adverse Events v.5 acute toxicity within 3 months after the end of treatment). Results: A total 943 patients participated in the MOMENTUM Study, 702 of whom had complete baseline data at the time of this analysis. Patients were primarily male (79%) with a median age of 68 years (range, 22-93) and were treated for 39 different indications. The most frequent indications were prostate (40%), oligometastatic lymph node (17%), brain (12%), and rectal (10%) cancers. The median number of fractions was 5 (range, 1-35). Six patients discontinued MR-Linac treatments, but none due to an inability to tolerate repeated high-field MRI. Of the 415 patients with complete data on acute toxicity at 3-month follow-up, 18 (4%) patients experienced grade 3 acute toxicity related to radiation. No grade 4 or 5 acute toxicity related to radiation was observed. Conclusions: In the first 21 months of our study, patterns of care were diverse with respect to clinical utilization, body sites, and radiation prescriptions. No patient discontinued treatment due to inability to tolerate daily high-field MRI scans, and the acute radiation toxicity experience was encouraging.
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U2 - 10.1016/j.ijrobp.2021.07.003
DO - 10.1016/j.ijrobp.2021.07.003
M3 - Article
C2 - 34265394
AN - SCOPUS:85113219681
SN - 0360-3016
VL - 111
SP - 867
EP - 875
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 4
ER -