MRI-guided prostate adaptive radiotherapy - A systematic review

Andrew Mcpartlin, X. A. Li, Lucy Kershaw, Uulke A van der Heide, L Kerkmeijer, C Lawton, Usman Mahmood, Floris J Pos, N Van As, Marcel Van Herk, D Vesprini, J van der Voort van Zyp, A Tree, Ananya Choudhury, MR-Linac consortium

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Abstract

Dose escalated radiotherapy improves outcomes for men with prostate cancer. A plateau for benefit from dose escalation using EBRT may not have been reached for some patients with higher risk disease. The use of increasingly conformal techniques, such as step and shoot IMRT or more recently VMAT, has allowed treatment intensification to be achieved whilst minimising associated increases in toxicity to surrounding normal structures. To support further safe dose escalation, the uncertainties in the treatment target position will need be minimised using optimal planning and image-guided radiotherapy (IGRT). In particular the increasing usage of profoundly hypo-fractionated stereotactic therapy is predicated on the ability to confidently direct treatment precisely to the intended target for the duration of each treatment. This article reviews published studies on the influences of varies types of motion on daily prostate position and how these may be mitigated to improve IGRT in future. In particular the role that MRI has played in the generation of data is discussed and the potential role of the MR-Linac in next-generation IGRT is discussed.

Original languageEnglish
Pages (from-to)371-380
Number of pages10
JournalRadiotherapy and Oncology
Volume119
Issue number3
Early online date6 May 2016
DOIs
Publication statusPublished - Jun 2016

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre

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