{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T04:06:05Z","timestamp":1751256365719,"version":"3.41.0"},"reference-count":8,"publisher":"Korean Society for Therapeutic Radiology and Oncology","issue":"2","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-roj.org"],"crossmark-restriction":true},"short-container-title":["Radiat Oncol J"],"published-print":{"date-parts":[[2025,6,30]]},"abstract":"<jats:p>This study evaluates the use of magnetic resonance\u2013guided radiation therapy (MRgRT) as an alternative to brachytherapy in treating para-urethral gynecological cancers, particularly for patients who are not candidates for brachytherapy. Five female patients with advanced para-urethral gynecological cancers underwent MRgRT using a custom 3-dimensional-printed intravaginal cylinder for image registration and treatment alignment. MRgRT was administered as a five-fraction adaptive boost following standard chemoradiation, with each fraction utilizing the cylinder to achieve precise positioning and improve organ sparing. A 1.5T magnetic resonance linear accelerator was used to deliver adapt-to-shape treatment, allowing real-time adjustments to compensate for anatomical variations. The cylinder served not only as a surrogate for accurate image registration but also as a spacer to displace the rectum from high-dose regions. The median follow-up period was 14.4 months, during which all patients completed treatment with no grade &gt;3 genitourinary toxicities. Acute toxicities included dysuria and vaginal pain, while chronic toxicities, such as urinary incontinence and mild cystitis, were recorded in a subset of patients. Treatment achieved an overall survival rate of 100% and a recurrence-free survival rate of 80%. Dosimetric analysis demonstrated effective target coverage with minimal exposure to surrounding organs, particularly sparing the urethra from hotspots, unlike traditional brachytherapy. These results suggest that MRgRT with a vaginal cylinder offers a promising approach for managing para-urethral gynecological cancers in patients ineligible for brachytherapy. Further studies are warranted to validate these findings and refine treatment protocols.<\/jats:p>","DOI":"10.3857\/roj.2024.00584","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:18:59Z","timestamp":1748996339000},"page":"104-108","update-policy":"https:\/\/doi.org\/10.3857\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Magnetic resonance linear accelerator boost for para-urethral cancer: a new treatment paradigm replacement for brachytherapy"],"prefix":"10.3857","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3228-2431","authenticated-orcid":true,"given":"Amir","family":"Owrangi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Star","family":"Okolie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Albuquerque","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2224","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2011.07.012"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2012.04.007"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2008.01.004"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1007\/s00066-003-1100-6"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.02.011"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/s1470-2045(19)30718-1"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-022-01981-z"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2023.11.036"}],"container-title":["Radiation Oncology Journal"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-roj.org\/upload\/pdf\/roj-2024-00584.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-roj.org\/journal\/view.php?doi=10.3857\/roj.2024.00584","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-roj.org\/upload\/pdf\/roj-2024-00584.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T23:19:47Z","timestamp":1751239187000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-roj.org\/journal\/view.php?doi=10.3857\/roj.2024.00584"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,30]]},"references-count":8,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,6]]}},"URL":"https:\/\/doi.org\/10.3857\/roj.2024.00584","relation":{},"ISSN":["2234-1900","2234-3156"],"issn-type":[{"type":"print","value":"2234-1900"},{"type":"electronic","value":"2234-3156"}],"subject":[],"published":{"date-parts":[[2025,6,30]]},"assertion":[{"value":"2024-08-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-04","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-30","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}