{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T16:20:44Z","timestamp":1762273244260,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,1,21]],"date-time":"2024-01-21T00:00:00Z","timestamp":1705795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Chronic Diseases and Translational Medicine"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Magnetic resonance (MR)\u2010guided ultra\u2010hypofractionated radiotherapy with whole\u2010pelvic irradiation (UHF\u2010WPRT) is a novel approach to radiotherapy for patients with high\u2010risk (HR) and very high\u2010risk (VHR) prostate cancer (PCa). However, the inherent complexity of adaptive UHF\u2010WPRT might inevitably result in longer on\u2010couch time. We aimed to estimate the delivered dose, study the feasibility and safety of adaptive UHF\u2010WPRT on a 1.5\u2010Tesla MR\u2010Linac.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten patients with clinical stage T3a\u20104N0\u20101M0\u20101c PCa, who consecutively received UHF\u2010WPRT, were enrolled prospectively. The contours of the target and organ\u2010at\u2010risks on the position verification\u2010MR (PV\u2010MR), beam\u2010on 3D\u2010MR(Bn\u2010MR), and post\u2010MR (after radiotherapy delivery) were derived from the pre\u2010MR data by deformable image registration. The physician then manually adjusted them, and dose recalculation was performed accordingly. GraphPad Prism 9 (GraphPad Prism Software Inc.) was utilized for conducting statistical analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, we collected 188 MR scans (50 pre\u2010MR, 50 PV\u2010MR, 44 Bn\u2010MR, and 44 post\u2010MR scans). With median 59\u2009min, the mean prostate clinical target volume (CTV)\u2010V<jats:sub>100%<\/jats:sub> was 98.59% \u00b1 2.74%, and the mean pelvic CTVp\u2010V<jats:sub>100%<\/jats:sub> relative percentages of all scans was 99.60% \u00b1 1.18%. The median V<jats:sub>29 Gy<\/jats:sub> change in the rectal wall was \u22122% (\u221218% to 20%). With a median follow\u2010up of 9 months, no patient had acute Common Terminology Criteria for Adverse Events (CTCAE) grade 2 or more severe genitourinary (GU) or gastrointestinal (GI) toxicities (0%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>UHF\u2010RT to the prostate and the whole pelvis with concomitant boost to positive nodes using an Adapt\u2010To\u2010Shape (ATS) workflow was technically feasible for patients with HR and VHR PCa, presenting only mild GU and GI toxicities. The estimated target dose during the beam\u2010on phase was clinically acceptable based on the 3D\u2010MR\u2013based dosimetry analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p>Chinese Clinical Trial Registry ChiCTR2000033382.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cdt3.114","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T05:15:12Z","timestamp":1705900512000},"page":"51-61","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Adaptive ultra\u2010hypofractionated whole\u2010pelvic radiotherapy in high\u2010risk and very high\u2010risk prostate cancer on 1.5\u2010Tesla MR\u2010Linac: Estimated delivered dose and early toxicity results"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2730-7910","authenticated-orcid":false,"given":"Linrui","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ran","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirui","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenlong","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongwen","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shulian","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Tang","sequence":"additional","affiliation":[{"name":"GCP Center\/Clinical Research Center, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Jing","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yueping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer 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