Patient-Reported Quality-of-Life Outcomes After Abdominopelvic Stereotactic Body Radiation Therapy Using an MR-Linac System.

Abstract

Despite the increasing use of MR-Linac (MRL) in the management of patients with oligometastatic or upper gastrointestinal malignancies, health-related quality-of-life (HRQoL) outcomes are lacking. Currently, it is not well established whether treatments using MRL offer HRQoL advantages over CT-based treatments. In this study, we present prospectively collected HRQoL data after abdominopelvic stereotactic body radiation therapy (SBRT) on a 1.5T MRL system. We conducted a single-center, prospective observational study of patients receiving MR guided adaptive radiotherapy using the MRL system from September 2019 to November 2024 at Princess Margaret Hospital for abdominopelvic targets. HRQoL assessment was performed using questionnaires from the European Organization for Research and Treatment of Cancer QLQ-C30. Linear mixed-effects models were used to compare the change in the HRQoL domain scores of the QLQ-C30 questionnaire within the MRL cohort from baseline to 3-month and 1-year follow-ups. Seventy-three patients were included in the analysis. Most patients had pelvic (43.8%) or abdominal (34.2%) targets. Following SBRT, 46.6% of the patients received systemic therapy. There was a significant increase in the symptom scale scores for fatigue (β = 8.9; 95% CI = 4.5, 13.2; P < .001) and nausea and vomiting (β = 3.9; 95% CI = 1.2, 6.6; P = .005) at the final fraction compared with baseline. Fatigue remained significantly increased from baseline to the first follow-up at 3 months (β = 4.7; 95% CI = 0.5, 9.0; P = .03). At 12 months, no significant difference was observed in any scale compared with baseline. Stereotactic radiation treatments using online adaptive MR guided radiation therapy on MRL are well tolerated in patients with abdominopelvic metastases, with HRQoL returning to baseline at 12 months.