Same-day MRI-LINAC guided single fraction radiosurgery for painful non-spine bone metastases
Eva-Maria Kretschmer,
Switzerland
PO-1607
Abstract
Same-day MRI-LINAC guided single fraction radiosurgery for painful non-spine bone metastases
Authors: Eva-Maria Kretschmer1, Michael Mayinger1, Madalyne Chamberlain2, Nienke Weitkamp1, Stefanie Ehrbar1, Marta Bogowicz1, Lotte Wilke1, Stephanie Tanadini-Lang1, Nicolaus Andratschke1, Matthias Guckenberger1, Helena Garcia1
1Universitätsspital Zürich, Klinik für Radio-Onkologie, Zürich, Switzerland; 2Universitätsspital Zürich, Klinik für Radio-Onkologie, Zürich, Germany
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Purpose or Objective
Recent data indicated improved efficacy of high-dose single-fraction stereotactic body radiotherapy (SBRT) for painful bone metastases. The aim of this study was to assess the feasibility of a same-day-workflow with MR-only planning and delivery in a single radiosurgical session without previous simulation, aiming to provide rapid pain relief.
Material and Methods
This prospective aquired, single-institution study enrolled patients with radiologically confirmed painful bone metastases with pain scores ≥ 3 / 10 (on 0 to 10 numeric rating scale= NRS). Patients received single-fraction SBRT with 12 Gy at an MR-Linac (ViewRay) with same-day planning and delivery of radiosurgery. We analyzed the procedure regarding process times, pain response, and treatment tolerance.
Results
15 patients were enrolled from June 2019 until January 2022 and 17 lesions have been irradiated. Mean age 63 years (range 30- 87 y). Mean GTV was 26.0 ccm, median was 15.6 ccm (range 1.1 to 84.4 ccm). Same-day SBRT planning and delivery was feasible and successfully performed in all patients. Median on-table time for contouring, SBRT planning and delivery was 65 minutes (range 57 – 112). No treatment interruption was observed. Median pre-treatment pain score was 6 points which was reduced to median NRS 0 (P=0.0028) at the 4-weeks follow-up. None of the patients developed a pain flare. No grade 3 or 4 toxicities were observed.
Conclusion
Same-day MR-guided SBRT planning and delivery for painful bone metastases was feasible and achieved promising pain response. Future prospective trials investigating this intervention are warranted, especially in palliative patients with a need for rapid pain response to improve quality of life.