Stereotactic body radiation therapy (SBRT) with MRI-Linac in oligometastatic gynaecological cancer patients: a systematic review.

INTRODUCTION

This review aims to provide a comprehensive overview of the current evidence on the use of MRI-guided SBRT for oligometastases in gynaecological cancers and its potential benefits.

MATERIALS AND

METHODS

Following PRISMA guidelines, we conducted a systematic review to identify studies focusing on MRI-guided SBRT for oligometastatic gynaecological cancer. Inclusion criteria specified English-language studies that reported clinical outcomes and toxicity data. Data extraction included study design, tumour characteristics, type of MRI-Linac utilized, treatment protocols, clinical outcomes, and toxicity profiles.

RESULTS

Of the 475 identified articles, three studies met the inclusion criteria, encompassing 45 patients with oligometastatic gynaecological cancers, predominantly ovarian, treated with 0.35-1.5 T MRI-Linac SBRT. Doses ranged from 30 to 50 Gy over five fractions. Focusing on actuarial outcome, all the patients were alive and maintained local control at 3 months from SBRT. The toxicity profile was available in all the studies, reporting only one Grade 3 event (gastro-intestinal), underscoring a favourable safety profile.

CONCLUSION

Despite some technical challenges, such as extended treatment times and limited MRI-Linac availability, MRI-guided SBRT appears to be a promising modality for oligometastatic ovarian cancer, potentially delaying the need for systemic therapy and chemotherapy line change. Larger studies are required to validate these findings and better establish the advantages relative to the use of this innovative approach.