John Christodouleas, SVP at Elekta, Medical Affairs and Attending Radiation Oncologist at Hospital of the University of Pennsylvania, shared on LinkedIn:
“My top 3 ‘most exciting’ clinical observations from Day 1 of the MR-Linac Consortium:
1. Esophageal adenocarcinoma: Integrating adaptive MR-guided SBRT to gross disease after neoadjuvant FLOT appears feasible and safe. Two targets using an SIB approach: pre-treatment gross disease and residual gross disease. 3-mm PTV margins. Phase 1 outcomes are maturing.
2. Direct-to-Unit (DTU) workflows: DTU has expanded well beyond inpatient palliative care: prostate SBRT, GBM, liver metastases, and oligometastatic lymph nodes. This has the potential to dramatically increase access to MR-Linacs.
3. Early-stage glottic cancer: Twice-weekly SBRT (8.5 Gy × 5) appears feasible and safe. 2-mm PTV margins, except 4 mm CC. No CTV. The target can be tracked using the cricoid. Phase 1 outcomes are maturing.
Bonus:
3b. GBM: FLAIR changes that emerge during long-course RT may have prognostic and/or predictive value. Seen in ~5–10% of patients.”
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