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Published on: March 24, 2022
Clinical Implementation of Dual-Isocenter Magnetic Resonance-Guided Radiation Therapy for Large-Target Cervical
Yifan Han1, Cong Wang2, Xun Wang1
1College of Clinical Medicine, North China University of Science and Technology, Tangshan, China; Cancer Hospital of Shandong First Medical University, Department of Radiation Physics and Technology, Jinan, China; Tangshan Cancer Hospital, Second Department of Chemoradiotherapy, Tangshan, China.
Purpose:
The purpose of this study was to investigate the feasibility of dual-isocenter (DI) radiation therapy under magnetic resonance linear accelerator (MR-Linac) guidance for patients with advanced cervical cancer.
Methods And Materials:
A total of 24 patients with cervical cancer treated with Elekta 1.5 T MR-Linac from September 2022 to December 2024 were enrolled. Patients were stratified into single-isocenter (SI) or DI radiation therapy groups based on craniocaudal tumor target size. Postradiation therapy toxicities (assessed up to February 2025), dosimetric data, and radiation treatment time were analyzed.
Results:
Among the 24 patients (median age, 59 years; range, 35-78 years), 10 received SI radiation therapy and 14 received DI radiation therapy. Key findings includes the following: (1) using Common Terminology Criteria for Adverse Events, version 5.0, systematic evaluation of skin, gastrointestinal, urinary, performance status, and gynecologic-related toxicities revealed no statistically significant differences in postradiation therapy toxicities between the 2 groups (P > .05); (2) dosimetric data for both groups were presented; (3) the mean treatment time for SI radiation therapy was 1337 seconds (approximately 22 minutes), compared with 2495 seconds (approximately 42 minutes) for DI radiation therapy.
Conclusions:
This study established a workflow for DI radiation therapy and demonstrated its feasibility through comparable toxicity profiles between DI and SI approaches. In addition, the dosimetric data and mean treatment time for both techniques in patients with cervical cancer provide a clinical foundation for magnetic resonance-guided radiation therapy using the Unity MR-Linac system.
