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BRIEF RESEARCH REPORT article

Front. Oncol.
Sec. Radiation Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1474115

Preliminary Experience using MR-guided Adaptive Radiotherapy in Head and Neck Cancer

Provisionally accepted
Caiden Atienza Caiden Atienza 1*Andrew Shepard Andrew Shepard 1,2Uwajachukwumma Uzomah Uwajachukwumma Uzomah 1Shri Kiriti Rajan Shri Kiriti Rajan 1Carryn M. Anderson Carryn M. Anderson 1Joel Katzer Joel Katzer 3,4Samuel Rusu Samuel Rusu 1Joel St-Aubin Joel St-Aubin 1Blake Smith Blake Smith 1Daniel Hyer Daniel Hyer 1
  • 1 Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
  • 2 Department of Human Oncology, University of Wisconsin-Madison, Madison, Wisconsin, United States
  • 3 Carver College of Medicine, The University of Iowa, Iowa City, Iowa, United States
  • 4 UnityPoint Health, Des Moines, Iowa, United States

The final, formatted version of the article will be published soon.

    This retrospective study evaluates the dosimetric benefits of adaptive radiotherapy for head and neck cancer patients. Five patients with node-positive oropharyngeal squamous cell carcinoma were treated with MR-guided radiotherapy using the Elekta Unity MR-Linac, undergoing 3-4 offline adaptive plan modifications during their treatment. This study compared the dose delivered to organs at risk (OARs) in a full offline adaptive approach versus an approach accounting only for daily setup. Results demonstrated a reduction in mean dose to critical structures in the offline adaptive arm. For example, the pharynx avoidance structure showed mean dose reductions ranging from 1.4 Gy to 3.6 Gy, and the left parotid gland exhibited reductions from 1.5 Gy to 1.9 Gy. Overall, offline adaptive radiotherapy reduced the mean cumulative dose to OARs in 19 of the 23 evaluated structures. Despite some instances of higher doses, the offline adaptive approach generally resulted in lower cumulative doses, emphasizing its potential to mitigate radiation-induced side effects. These findings suggest that offline adaptive radiotherapy has the potential to enhance treatment efficacy by better accommodating anatomical changes during therapy, thereby improving patient outcomes and reducing treatmentrelated morbidity.

    Keywords: Adaptive, Radiotherapy, benefit, MR-linac, Organs-at-risk

    Received: 01 Aug 2024; Accepted: 21 Oct 2024.

    Copyright: © 2024 Atienza, Shepard, Uzomah, Rajan, Anderson, Katzer, Rusu, St-Aubin, Smith and Hyer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Caiden Atienza, Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, 52242, Iowa, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.