{"doi":"10.1016/j.phro.2022.10.003","title":"Stereotactic ablative radiation for pancreatic cancer on a 1.5 Telsa magnetic resonance-linac system","abstract":"Purpose: Ablative radiation therapy (A-RT) appears to improve outcomes in locally advanced pancreatic cancer (LAPC) yet requires solutions for respiratory and digestive motion. We report outcomes of A-RT for pancreatic cancer using 1.5 T MR-adaptive treatment delivery. Methods: Between March 2020 and July 2021, we treated 30 patients with pancreatic cancer with 50 Gy in 5 fractions (biologically effective dose [BED10] = 100 Gy10) using a novel compression belt workflow and remote planning on the Unity 1.5 T MR linac system. Cumulative incidence of progression was computed from A-RT initiation with death as a competing risk. Overall (OS) and progression-free survival (PFS) were calculated using Kaplan Meier methods. Results: Of 30 patients, most (73 %) were locally advanced, 4 (13 %) were metastatic, 2 (7 %) were medically inoperable, and 2 (7 %) were locally recurrent. Most (73 %) received FOLFIRINOX prior to A-RT. Median follow-up times from diagnosis and A-RT were 17.6 (IQR 15.8-23.1) and 11.5 months (IQR 9.7-16.1), respectively. Cumulative incidences at 1-year of local and distant progression were 19.3 % (95 %CI 6.7-36.8 %) and 47.4 % (95 %CI 26.7-65.6 %), respectively. Median OS from diagnosis and A-RT were not reached. One-year OS from diagnosis and A-RT were 96.4 % (95 %CI 77.2-99.5 %) and 80.0 % (95 %CI 57.3-91.4 %), respectively. Median and 1-year PFS were 10.1 months (95 %CI 4.4-14.4) and 39.7 % (95 %CI 20.3-58.5 %), respectively. No grade 3 + toxicities were observed. Conclusions: A-RT using the 1.5 T Unity MR Linac resulted in promising LC and OS with no severe toxicity in patients with LAPC despite radiosensitive organs adjacent to the target volumes. Longer follow-up is needed to assess long-term outcomes.","journal":"Physics and Imaging in Radiation Oncology","year":2022,"id":243690,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":33,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9549,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":395956,"name":"Neelam Tyagi","orcid":"0000-0002-6256-7817","position":1,"is_corresponding":false},{"id":377112,"name":"Marsha Reyngold","orcid":"0000-0001-9475-146X","position":2,"is_corresponding":false},{"id":228776,"name":"Paul B. Romesser","orcid":"0000-0001-8268-2903","position":3,"is_corresponding":false},{"id":245117,"name":"Abraham J. Wu","orcid":"0000-0002-2597-7091","position":4,"is_corresponding":false},{"id":242198,"name":"Eileen M. O’Reilly","orcid":"0000-0002-8076-9199","position":5,"is_corresponding":false},{"id":90751,"name":"Anna M. Varghese","orcid":"0000-0001-5426-0885","position":6,"is_corresponding":false},{"id":656139,"name":"Paola Godoy Scripes","orcid":null,"position":7,"is_corresponding":false},{"id":242191,"name":"Danny N. Khalil","orcid":"0000-0003-4688-0958","position":8,"is_corresponding":false},{"id":242186,"name":"Wungki Park","orcid":"0000-0002-8006-3102","position":9,"is_corresponding":false},{"id":242188,"name":"Kenneth H. Yu","orcid":"0000-0002-4774-2672","position":10,"is_corresponding":false},{"id":305046,"name":"Christopher H. Crane","orcid":"0000-0001-5143-2784","position":11,"is_corresponding":false},{"id":329264,"name":"Kathryn R. Tringale","orcid":"0000-0002-1506-4870","position":0,"is_corresponding":true}],"reference_count":32,"raw_metadata":null,"created_at":"2026-07-19T00:23:20.901576Z","pmid":"36386447","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}