{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T13:29:09Z","timestamp":1770730149810,"version":"3.49.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100024211","name":"Acibadem Mehmet Ali Aydinlar University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100024211","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Strahlenther Onkol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>Stereotactic body radiotherapy (SBRT) is associated with good local control and symptom relief in the management of spinal metastases. Delivery of ablative doses and re-irradiation is challenged by spinal cord toxicity. We hypothesized that lower spinal cord doses as well as better target coverage could be yielded with stereotactic magnetic resonance-guided adaptive radiotherapy (SMART).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Institutional records were reviewed to retrieve patients who received online MR-guided SBRT for spinal metastases. Each fraction was reviewed to determine the necessity of adaptive planning, to identify reasons for violations that required adaptive planning, and to assess the spinal cord dose. The study also evaluated how adaptive planning contributed to reducing spinal cord doses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A\u00a0total of 34\u00a0patients with 61\u00a0lesions were included. The treatment intent was definitive for 47\u00a0(77.1%), palliative for 12 (19.7%), and postoperative for two (3.3%) lesions. The median prescribed Biological Equivalent Dose (BED)\n                      <jats:sub>10<\/jats:sub>\n                      was 51.3\u202fGy. Treatment plans often required adaptive adjustments (81.8%). Adaptive planning significantly improved target coverage (median PTV coverage 92.75% vs. 95%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090.001) and reduced spinal cord D\n                      <jats:sub>max<\/jats:sub>\n                      (median spinal cord D\n                      <jats:sub>max<\/jats:sub>\n                      constraint: 7.3\u202fGy, median predicted spinal cord D\n                      <jats:sub>max<\/jats:sub>\n                      : 7.76, and median adaptive spinal cord D\n                      <jats:sub>max<\/jats:sub>\n                      6.18;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090.001). Lesion-based median follow-up from irradiation was 7.5\u00a0months (range: 1\u201346\u00a0months). One-year LPFS was 94.3%. Six lesions progressed and none of the progressed lesions received a\u00a0dose above the median BED\n                      <jats:sub>10<\/jats:sub>\n                      of 51.3\u202fGy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Herein we present our institutional experience with SMART for spinal bone metastases. According to our results, adaptive planning yields better target coverage as well as lower spinal cord doses compared to the predicted plan, which translates into a\u00a0feasible method for delivering SBRT. Future prospective studies evaluating spinal SMART are awaited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00066-025-02401-3","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T14:05:57Z","timestamp":1745849157000},"page":"1289-1295","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Initial experience with MR-guided adaptive spinal stereotactic radiotherapy: a\u00a0new indication for the MR-linac"],"prefix":"10.1007","volume":"201","author":[{"given":"Neris","family":"Dincer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teuta","family":"Zoto Mustafayev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ceren","family":"Atahan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gorkem","family":"Gungor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gamze","family":"Ugurluer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet Ufuk","family":"Abacioglu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enis","family":"Ozyar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8435-8074","authenticated-orcid":false,"given":"Banu","family":"Atalar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"issue":"10","key":"2401_CR1","doi-asserted-by":"publisher","first-page":"216","DOI":"10.21037\/atm.2019.04.83","volume":"7","author":"AT Yahanda","year":"2019","unstructured":"Yahanda\u00a0AT, Buchowski\u00a0JM, Wegner\u00a0AM (2019) Treatment, complications, and outcomes of metastatic disease of the spine: from patchell to PROMIS. 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