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Cited by Other Article(s)

Guerini AE, Nici S, Riga S, Pegurri L, Borghetti P, Mataj E, Balduzzi J, Katica M, Cossali G, Facheris G, Triggiani L, Sakiri A, Spiazzi L, Magrini SM, Buglione M. Treatment of Non-Hodgkin Lymphoma Involving Head and Neck Sites with a 1.5 T MR-Linac: Preliminary Results from a Prospective Observational Study. Hematol Rep 2025;17:16. [PMID: 40277840 PMCID: PMC12026517 DOI: 10.3390/hematolrep17020016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2024] [Revised: 03/10/2025] [Accepted: 03/25/2025] [Indexed: 04/26/2025] Open

Abstract

Purpose: Lymphomas are generally radiosensitive; therefore, disease volume tends to shrink during radiotherapy courses. As MRI-linac provides excellent soft tissue definition and allows daily re-contouring of gross tumor volume and clinical target volume, its adoption could be beneficial for the treatment of lymphomas. Nonetheless, at this time there is a lack of literature regarding the use of MR-linac in this context. Methods: A prospective observational study was conducted on patients affected by non-Hodgkin lymphoma (NHL) involving head and neck (H&N) sites and treated with Elekta Unity® MR-Linac. The clinical and dosimetric data of the first eight patients were collected and integrated with relevant data from medical records. Results: Seven patients had B-cell lymphoma (three DLBCL, two MALT, one follicular, and one mantle-cell) and one T-cell/NK lymphoma. The intent of RT was radical for four patients, salvage treatment for three, and CAR-T bridging for one. Two patients presented orbital localizations and six cervical lymphonodal sites. Median GTV was 5.74 cc, median CTV 127.01 cc, and median PTV 210.37 cc. The prescribed dose was 24-50 Gy in 2 Gy fractions for seven patients and 24 Gy in 3 Gy fractions for one patient. All the patients experienced acute toxicity, the maximum grade was G1 for five patients and G2 for three at the end of RT. One month after radiotherapy seven patients still experienced G1 toxicity, but no toxicity grade ≥ 2 was reported. First radiological assessment was performed for all the patients after a median of 101.5 days, reporting complete response in all the cases. After a median follow up of 330 days, no patient experienced local disease progression, while one patient developed distant progression. Conclusions: radiotherapy for NHL with H&N localization using a 1.5 T MR-linac was feasible, with no >G2 toxicity and optimal response rate and disease control.

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Affiliation(s)

Andrea Emanuele Guerini Department of Radiation Oncology, University of Brescia, 25123 Brescia, Italy; (L.P.); (P.B.); (E.M.); (J.B.); (M.K.); (G.C.); (G.F.); (L.T.); (A.S.); (S.M.M.); (M.B.) ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
Stefania Nici Medical Physics Department, ASST Spedali Civili Hospital, 25123 Brescia, Italy; (S.R.); (L.S.)
Stefano Riga Medical Physics Department, ASST Spedali Civili Hospital, 25123 Brescia, Italy; (S.R.); (L.S.)
Ludovica Pegurri Department of Radiation Oncology, University of Brescia, 25123 Brescia, Italy; (L.P.); (P.B.); (E.M.); (J.B.); (M.K.); (G.C.); (G.F.); (L.T.); (A.S.); (S.M.M.); (M.B.) ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
Paolo Borghetti Department of Radiation Oncology, University of Brescia, 25123 Brescia, Italy; (L.P.); (P.B.); (E.M.); (J.B.); (M.K.); (G.C.); (G.F.); (L.T.); (A.S.); (S.M.M.); (M.B.) ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
Eneida Mataj Department of Radiation Oncology, University of Brescia, 25123 Brescia, Italy; (L.P.); (P.B.); (E.M.); (J.B.); (M.K.); (G.C.); (G.F.); (L.T.); (A.S.); (S.M.M.); (M.B.) ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
Jacopo Balduzzi Department of Radiation Oncology, University of Brescia, 25123 Brescia, Italy; (L.P.); (P.B.); (E.M.); (J.B.); (M.K.); (G.C.); (G.F.); (L.T.); (A.S.); (S.M.M.); (M.B.) ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
Mirsada Katica Department of Radiation Oncology, University of Brescia, 25123 Brescia, Italy; (L.P.); (P.B.); (E.M.); (J.B.); (M.K.); (G.C.); (G.F.); (L.T.); (A.S.); (S.M.M.); (M.B.) ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
Gianluca Cossali Department of Radiation Oncology, University of Brescia, 25123 Brescia, Italy; (L.P.); (P.B.); (E.M.); (J.B.); (M.K.); (G.C.); (G.F.); (L.T.); (A.S.); (S.M.M.); (M.B.) ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
Giorgio Facheris Department of Radiation Oncology, University of Brescia, 25123 Brescia, Italy; (L.P.); (P.B.); (E.M.); (J.B.); (M.K.); (G.C.); (G.F.); (L.T.); (A.S.); (S.M.M.); (M.B.) ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
Luca Triggiani Department of Radiation Oncology, University of Brescia, 25123 Brescia, Italy; (L.P.); (P.B.); (E.M.); (J.B.); (M.K.); (G.C.); (G.F.); (L.T.); (A.S.); (S.M.M.); (M.B.) ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy
Albert Sakiri Department of Radiation Oncology, University of Brescia, 25123 Brescia, Italy; (L.P.); (P.B.); (E.M.); (J.B.); (M.K.); (G.C.); (G.F.); (L.T.); (A.S.); (S.M.M.); (M.B.)
Luigi Spiazzi Medical Physics Department, ASST Spedali Civili Hospital, 25123 Brescia, Italy; (S.R.); (L.S.) Centro per lo Studio della Radioterapia guidata dalle Immagini e dai Biomarkers (BIO-RT), Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, University of Brescia, 25121 Brescia, Italy
Stefano Maria Magrini Department of Radiation Oncology, University of Brescia, 25123 Brescia, Italy; (L.P.); (P.B.); (E.M.); (J.B.); (M.K.); (G.C.); (G.F.); (L.T.); (A.S.); (S.M.M.); (M.B.) ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy Centro per lo Studio della Radioterapia guidata dalle Immagini e dai Biomarkers (BIO-RT), Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, University of Brescia, 25121 Brescia, Italy
Michela Buglione Department of Radiation Oncology, University of Brescia, 25123 Brescia, Italy; (L.P.); (P.B.); (E.M.); (J.B.); (M.K.); (G.C.); (G.F.); (L.T.); (A.S.); (S.M.M.); (M.B.) ASST Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy Centro per lo Studio della Radioterapia guidata dalle Immagini e dai Biomarkers (BIO-RT), Dipartimento di Specialità Medico-Chirurgiche, Scienze Radiologiche e Sanità Pubblica, University of Brescia, 25121 Brescia, Italy

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Buglione M, Guerini AE, Filippi AR, Spiazzi L, Pasinetti N, Magli A, Toraci C, Borghetti P, Triggiani L, Alghisi A, Costantino G, Bertagna F, Giaj Levra N, Pegurri L, Magrini SM. A Systematic Review on Intensity Modulated Radiation Therapy for Mediastinal Hodgkin's Lymphoma. Crit Rev Oncol Hematol 2021;167:103437. [PMID: 34358649 DOI: 10.1016/j.critrevonc.2021.103437] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 05/20/2021] [Accepted: 07/28/2021] [Indexed: 02/07/2023] Open

Affiliation(s)

Michela Buglione Università degli Studi di Brescia, Department of Radiation Oncology, Brescia University, P.le Spedali Civili 1, 25123 Brescia, Italy.
Andrea Emanuele Guerini Università degli Studi di Brescia, Department of Radiation Oncology, Brescia University, P.le Spedali Civili 1, 25123 Brescia, Italy.
Andrea Riccardo Filippi Radiation Oncology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy.
Luigi Spiazzi Department of Radiation Oncology, ASST Spedali Civili di Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy.
Nadia Pasinetti Università degli Studi di Brescia, Department of Radiation Oncology, Brescia University, P.le Spedali Civili 1, 25123 Brescia, Italy; Radiation Oncology Service, ASST Valcamonica Esine, Italy.
Alessandro Magli Department of Radiation Oncology, Udine General Hospital, Udine, Italy.
Cristian Toraci Department of Radiation Oncology, ASST Spedali Civili di Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy.
Paolo Borghetti Department of Radiation Oncology, ASST Spedali Civili di Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy.
Luca Triggiani Università degli Studi di Brescia, Department of Radiation Oncology, Brescia University, P.le Spedali Civili 1, 25123 Brescia, Italy.
Alessandro Alghisi Department of Radiation Oncology, Alessandro Manzoni Hospital, Lecco, Italy.
Gianluca Costantino Radiation Oncology Service, ASST Valcamonica Esine, Italy.
Francesco Bertagna Nuclear Medicine Department, University of Brescia and Spedali Civili of Brescia, Brescia, Italy.
Niccolò Giaj Levra Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Italy.
Ludovica Pegurri Department of Radiation Oncology, ASST Spedali Civili di Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy.
Stefano Maria Magrini Università degli Studi di Brescia, Department of Radiation Oncology, Brescia University, P.le Spedali Civili 1, 25123 Brescia, Italy.

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Guerini AE, Filippi AR, Tucci A, Simontacchi G, Re A, Guaineri A, Morelli V, Borghetti P, Triggiani L, Pegurri L, Pedretti S, Volpi G, Spiazzi L, Magrini SM, Buglione M. 'Le Roi est mort, vive le Roi': New Roles of Radiotherapy in the Treatment of Lymphomas in Combination With Immunotherapy. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2021;22:e135-e148. [PMID: 34728169 DOI: 10.1016/j.clml.2021.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/27/2021] [Accepted: 09/06/2021] [Indexed: 12/19/2022]