MR-Guided Adaptive Radiotherapy for Head and Neck Cancer: Prospective Evaluation of Migration and Anatomical Changes of the Major Salivary Glands

The aim of this study was to quantify anatomical changes of parotids and submandibular glands and evaluate potential dosimetric advantages during weekly adaptive MR-guided radiotherapy (MRgRT) for the definitive treatment of head and neck cancer (HNC). The data and plans of 12 patients treated with...

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Autores principales:	Janita E. van Timmeren, Madalyne Chamberlain, Marta Bogowicz, Stefanie Ehrbar, Riccardo Dal Bello, Helena Garcia Schüler, Jérôme Krayenbuehl, Lotte Wilke, Nicolaus Andratschke, Matthias Guckenberger, Stephanie Tanadini-Lang, Panagiotis Balermpas
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	head and neck cancer image-guided radiotherapy MRI-linac adaptive radiotherapy parotid glands submandibular glands Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/154a0a79c58e4897a51fad65e2355cb6
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spelling	oai:doaj.org-article:154a0a79c58e4897a51fad65e2355cb62021-11-11T15:30:23ZMR-Guided Adaptive Radiotherapy for Head and Neck Cancer: Prospective Evaluation of Migration and Anatomical Changes of the Major Salivary Glands10.3390/cancers132154042072-6694https://doaj.org/article/154a0a79c58e4897a51fad65e2355cb62021-10-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/21/5404https://doaj.org/toc/2072-6694The aim of this study was to quantify anatomical changes of parotids and submandibular glands and evaluate potential dosimetric advantages during weekly adaptive MR-guided radiotherapy (MRgRT) for the definitive treatment of head and neck cancer (HNC). The data and plans of 12 patients treated with bilateral intensity-modulated radiotherapy for HNC using MR-linac, with weekly offline adaptations, were prospectively evaluated. The positional and volumetric changes of the salivary glands were analyzed by manual segmentation in weekly MRI images and the dosimetric impact of these anatomical changes on the adapted treatment plans was assessed. The mean volume change in parotid and submandibular gland volume was −31.9% (<i>p</i> < 0.0001) and −29.7% (<i>p</i> < 0.0001) after five weeks, respectively. The volume change was significantly correlated with the cumulative dose for the respective gland at the time of volume measurement. Inter-parotid distance changed by −5.4% (6.5 mm) on average after five weeks (<i>p</i> = 0.0005). The distance became significantly smaller only in the left-right direction. The inter-submandibular gland distance changed by 0.7 mm (<i>p</i> = 0.38). This study demonstrated significant changes in salivary gland volumes and position following daily MR guidance and weekly plan adaptation. Ongoing clinical trials will provide data on the clinical impact of these changes and novel MR-based adaptation strategies.Janita E. van TimmerenMadalyne ChamberlainMarta BogowiczStefanie EhrbarRiccardo Dal BelloHelena Garcia SchülerJérôme KrayenbuehlLotte WilkeNicolaus AndratschkeMatthias GuckenbergerStephanie Tanadini-LangPanagiotis BalermpasMDPI AGarticlehead and neck cancerimage-guided radiotherapyMRI-linacadaptive radiotherapyparotid glandssubmandibular glandsNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5404, p 5404 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	head and neck cancer image-guided radiotherapy MRI-linac adaptive radiotherapy parotid glands submandibular glands Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	head and neck cancer image-guided radiotherapy MRI-linac adaptive radiotherapy parotid glands submandibular glands Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Janita E. van Timmeren Madalyne Chamberlain Marta Bogowicz Stefanie Ehrbar Riccardo Dal Bello Helena Garcia Schüler Jérôme Krayenbuehl Lotte Wilke Nicolaus Andratschke Matthias Guckenberger Stephanie Tanadini-Lang Panagiotis Balermpas MR-Guided Adaptive Radiotherapy for Head and Neck Cancer: Prospective Evaluation of Migration and Anatomical Changes of the Major Salivary Glands
description	The aim of this study was to quantify anatomical changes of parotids and submandibular glands and evaluate potential dosimetric advantages during weekly adaptive MR-guided radiotherapy (MRgRT) for the definitive treatment of head and neck cancer (HNC). The data and plans of 12 patients treated with bilateral intensity-modulated radiotherapy for HNC using MR-linac, with weekly offline adaptations, were prospectively evaluated. The positional and volumetric changes of the salivary glands were analyzed by manual segmentation in weekly MRI images and the dosimetric impact of these anatomical changes on the adapted treatment plans was assessed. The mean volume change in parotid and submandibular gland volume was −31.9% (<i>p</i> < 0.0001) and −29.7% (<i>p</i> < 0.0001) after five weeks, respectively. The volume change was significantly correlated with the cumulative dose for the respective gland at the time of volume measurement. Inter-parotid distance changed by −5.4% (6.5 mm) on average after five weeks (<i>p</i> = 0.0005). The distance became significantly smaller only in the left-right direction. The inter-submandibular gland distance changed by 0.7 mm (<i>p</i> = 0.38). This study demonstrated significant changes in salivary gland volumes and position following daily MR guidance and weekly plan adaptation. Ongoing clinical trials will provide data on the clinical impact of these changes and novel MR-based adaptation strategies.
format	article
author	Janita E. van Timmeren Madalyne Chamberlain Marta Bogowicz Stefanie Ehrbar Riccardo Dal Bello Helena Garcia Schüler Jérôme Krayenbuehl Lotte Wilke Nicolaus Andratschke Matthias Guckenberger Stephanie Tanadini-Lang Panagiotis Balermpas
author_facet	Janita E. van Timmeren Madalyne Chamberlain Marta Bogowicz Stefanie Ehrbar Riccardo Dal Bello Helena Garcia Schüler Jérôme Krayenbuehl Lotte Wilke Nicolaus Andratschke Matthias Guckenberger Stephanie Tanadini-Lang Panagiotis Balermpas
author_sort	Janita E. van Timmeren
title	MR-Guided Adaptive Radiotherapy for Head and Neck Cancer: Prospective Evaluation of Migration and Anatomical Changes of the Major Salivary Glands
title_short	MR-Guided Adaptive Radiotherapy for Head and Neck Cancer: Prospective Evaluation of Migration and Anatomical Changes of the Major Salivary Glands
title_full	MR-Guided Adaptive Radiotherapy for Head and Neck Cancer: Prospective Evaluation of Migration and Anatomical Changes of the Major Salivary Glands
title_fullStr	MR-Guided Adaptive Radiotherapy for Head and Neck Cancer: Prospective Evaluation of Migration and Anatomical Changes of the Major Salivary Glands
title_full_unstemmed	MR-Guided Adaptive Radiotherapy for Head and Neck Cancer: Prospective Evaluation of Migration and Anatomical Changes of the Major Salivary Glands
title_sort	mr-guided adaptive radiotherapy for head and neck cancer: prospective evaluation of migration and anatomical changes of the major salivary glands
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/154a0a79c58e4897a51fad65e2355cb6
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MR-Guided Adaptive Radiotherapy for Head and Neck Cancer: Prospective Evaluation of Migration and Anatomical Changes of the Major Salivary Glands

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