Stereotactic MR-Guided Radiotherapy for Adrenal Gland Metastases: First Clinical Results

Morgan Michalet; Ons Bettaïeb; Samia Khalfi; Asma Ghorbel; Simon Valdenaire; Pierre Debuire; Norbert Aillères; Roxana Draghici; Mailys De Méric De Bellefon; Marie Charissoux; Pierre Boisselier; Sylvain Demontoy; Alexis Marguerit; Morgane Cabaillé; Marie Cantaloube; Aïcha Keskes; Touria Bouhafa; Marie-Pierre Farcy-Jacquet; Pascal Fenoglietto; David Azria; Olivier Riou

doi:10.3390/jcm12010291

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Stereotactic MR-Guided Radiotherapy for Adrenal Gland Metastases: First Clinical Results

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Stereotactic MR-Guided Radiotherapy for Adrenal Gland Metastases: First Clinical Results

Morgan Michalet, Ons Bettaïeb, Samia Khalfi, Asma Ghorbel, Simon Valdenaire, Pierre Debuire, Norbert Aillères, Roxana Draghici, Mailys De Méric De Bellefon, Marie Charissoux, …

Journal of clinical medicine, Vol.12(1), p.291

30/12/2022

DOI: https://doi.org/10.3390/jcm12010291

PMID: 36615093

Résumé

Stereotactic MR-guided Radiotherapy (MRgRT) is an interesting treatment option for adrenal gland metastases (AGM). We reviewed data from 12 consecutive patients treated with MRgRT for an AGM in our center between 14 November 2019 and 17 August 2021. Endpoints were tolerance assessment, the impact of adaptive treatment on target volume coverage and organs at risk (OAR) sparing, local control (LC), and overall survival (OS). The majority of patients were oligometastatic (58.3%), with 6 right AGM, 5 left AGM and 1 left and right AGM. The prescribed dose was 35 to 50 Gy in 3 to 5 fractions. The median PTV V95% on the initial plan was 95.74%. The median V95% of the PTVoptimized (PTVopt) on the initial plan was 95.26%. Thirty-eight (69%) fractions were adapted. The PTV coverage was significantly improved for adapted plans compared to predicted plans (median PTV V95% increased from 89.85% to 91.17%, p = 0.0478). The plan adaptation also significantly reduced Dmax for the stomach and small intestine. The treatment was well tolerated with no grade > 2 toxicities. With a median follow-up of 15.5 months, the 1–year LC and OS rate were 100% and 91.7%. Six patients (50%) presented a metastatic progression, and one patient (8.3%) died of metastatic evolution during the follow-up. Adaptation of the treatment plan improved the overall dosimetric quality of MRI-guided radiotherapy. A longer follow-up is required to assess late toxicities and clinical results.

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Titre: Stereotactic MR-Guided Radiotherapy for Adrenal Gland Metastases: First Clinical Results
Créateurs - sans rôle: Morgan Michalet - Montpellier Cancer Institute, Federation of Radiation Oncology of Mediterranean Occitanie, University Montpellier, INSERM U1194 IRCM, 34298 Montpellier, France CHU Hassan II, Radiotherapy and Brachyterapy, 30050 Fez, Morocco Institut de Cancérologie du Gard, University Federation of Radiation Oncology of Mediterranean Occitanie, CHU Carémeau, 30900 Nîmes, France
Ons Bettaïeb - Montpellier Cancer Institute, Federation of Radiation Oncology of Mediterranean Occitanie, University Montpellier, INSERM U1194 IRCM, 34298 Montpellier, France CHU Hassan II, Radiotherapy and Brachyterapy, 30050 Fez, Morocco Institut de Cancérologie du Gard, University Federation of Radiation Oncology of Mediterranean Occitanie, CHU Carémeau, 30900 Nîmes, France
Samia Khalfi - Montpellier Cancer Institute, Federation of Radiation Oncology of Mediterranean Occitanie, University Montpellier, INSERM U1194 IRCM, 34298 Montpellier, France CHU Hassan II, Radiotherapy and Brachyterapy, 30050 Fez, Morocco Institut de Cancérologie du Gard, University Federation of Radiation Oncology of Mediterranean Occitanie, CHU Carémeau, 30900 Nîmes, France
Asma Ghorbel - Montpellier Cancer Institute, Federation of Radiation Oncology of Mediterranean Occitanie, University Montpellier, INSERM U1194 IRCM, 34298 Montpellier, France CHU Hassan II, Radiotherapy and Brachyterapy, 30050 Fez, Morocco Institut de Cancérologie du Gard, University Federation of Radiation Oncology of Mediterranean Occitanie, CHU Carémeau, 30900 Nîmes, France
Simon Valdenaire - Institut de Recherche en Cancérologie de Montpellier
Pierre Debuire - Institut de Recherche en Cancérologie de Montpellier
Norbert Aillères - Institut de Recherche en Cancérologie de Montpellier
Roxana Draghici - Institut de Recherche en Cancérologie de Montpellier
Mailys De Méric De Bellefon - Institut de Recherche en Cancérologie de Montpellier
Marie Charissoux - Institut de Recherche en Cancérologie de Montpellier
Pierre Boisselier - Institut de Recherche en Cancérologie de Montpellier
Sylvain Demontoy - Institut de Recherche en Cancérologie de Montpellier
Alexis Marguerit - Montpellier Cancer Institute, Federation of Radiation Oncology of Mediterranean Occitanie, University Montpellier, INSERM U1194 IRCM, 34298 Montpellier, France CHU Hassan II, Radiotherapy and Brachyterapy, 30050 Fez, Morocco Institut de Cancérologie du Gard, University Federation of Radiation Oncology of Mediterranean Occitanie, CHU Carémeau, 30900 Nîmes, France
Morgane Cabaillé - Institut de Recherche en Cancérologie de Montpellier
Marie Cantaloube - Institut de Recherche en Cancérologie de Montpellier
Aïcha Keskes - Institut de Recherche en Cancérologie de Montpellier
Touria Bouhafa - Montpellier Cancer Institute, Federation of Radiation Oncology of Mediterranean Occitanie, University Montpellier, INSERM U1194 IRCM, 34298 Montpellier, France CHU Hassan II, Radiotherapy and Brachyterapy, 30050 Fez, Morocco Institut de Cancérologie du Gard, University Federation of Radiation Oncology of Mediterranean Occitanie, CHU Carémeau, 30900 Nîmes, France
Marie-Pierre Farcy-Jacquet - Montpellier Cancer Institute, Federation of Radiation Oncology of Mediterranean Occitanie, University Montpellier, INSERM U1194 IRCM, 34298 Montpellier, France CHU Hassan II, Radiotherapy and Brachyterapy, 30050 Fez, Morocco Institut de Cancérologie du Gard, University Federation of Radiation Oncology of Mediterranean Occitanie, CHU Carémeau, 30900 Nîmes, France
Pascal Fenoglietto - Institut de Recherche en Cancérologie de Montpellier
David Azria - Institut de Recherche en Cancérologie de Montpellier
Olivier Riou - Institut de Recherche en Cancérologie de Montpellier
Détails de publication: Journal of clinical medicine, Vol.12(1), p.291
Éditeur: MDPI
Identifiants: 99141175409311
Unité académique: Institut de Recherche en Cancérologie de Montpellier - IRCM
Langue: English
Type de ressource: Journal article