Authors' objectives: The objective of this Health Technology Assessment (HTA) was to assess whether MRgRT improves treatment results of radiotherapy (RT) in patients with cancer in thorax, or abdomen/pelvis, or head and neck compared to current methods. Overall survival and health related quality of life (HRQL) were considered critical outcomes for decision making. Important outcomes were toxicity, progressionfree survival, treatment time (in machine), target coverage, proportion of cases with replanning of treatment, organs at risk constraint violations (ie exceeding specified exposure limits for organs at risk during a treatment session), patient treatment experience, and partial / complete response.

Authors' results and conclusions: For critical clinical outcomes - overall survival and HRQL - no comparisons of MRgRT with current methods are available. This also holds for the important outcomes toxicity, progression-free survival, treatment time, patient treatment experience and partial or complete response. For two intermediate endpoints within-subject comparisons of treatment plans based on both methods – using the new technique as reference standard - are available: the new technique may be associated with a higher proportion of treatment sessions reaching target coverage goals and a lower number of treatment sessions with violations of organs at risk constraints. However, the extent of improvement varied substantially between studies and the certainty of evidence is low. It remains to be seen, whether, and for which patient population the reported advantage in intermediate endpoints may translate into an improved benefit risk balance of the new compared to the present technique. Treatment sessions with MRgRT are presumably 3-4 times longer than with current methods, and the need to stay in the same body position during extended times may be difficult for elderly as well as patients in pain. Economic aspects including high investment costs and the considerable increase in time and clinical staff needed for MRgRT are further challenges and imply a risk for displacement effects.

Project Status: Completed

Year Published: 2020

URL for published report: https://mellanarkiv-offentlig.vgregion.se/alfresco/s/archive/stream/public/v1/source/available/sofia/su4372-1728378332-388/surrogate/2020_116%20HTA-rapport%20MR%20Linac.pdf

English language abstract: An English language summary is available

Publication Type: Full HTA

Organisation Name: The Regional Health Technology Assessment Centre

Contact Address: The Regional Health Technology Assessment Centre, Region Vastra Gotaland, HTA-centrum, Roda Straket 8, Sahlgrenska Universitetssjukhuset, 413 45 GOTHENBORG, Sweden

Contact Name: hta-centrum@vgregion.se

Contact Email: hta-centrum@vgregion.se