title: MRI-guided prostate adaptive radiotherapy - A systematic review.
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.
authors.affiliation: The Christie NHS Foundation Trust and Manchester Cancer Research Centre, University of Manchester, Manchester Academic Health Sciences Centre, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: McPartlin
authors.affiliation: Medical College of Wisconsin, USA.
authors.forename: X A
authors.initials: XA
authors.lastname: Li
authors.affiliation: The Christie NHS Foundation Trust and Manchester Cancer Research Centre, University of Manchester, Manchester Academic Health Sciences Centre, UK.
authors.forename: L E
authors.initials: LE
authors.lastname: Kershaw
authors.affiliation: Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, The Netherlands.
authors.forename: U
authors.initials: U
authors.lastname: Heide
authors.affiliation: University Medical Center Utrecht, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Kerkmeijer
authors.affiliation: Medical College of Wisconsin, USA.
authors.forename: C
authors.initials: C
authors.lastname: Lawton
authors.affiliation: MD Anderson Cancer Center, Houston, USA.
authors.forename: U
authors.initials: U
authors.lastname: Mahmood
authors.affiliation: Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Pos
authors.affiliation: Royal Marsden Hospital, UK; Institute of Cancer Research, UK.
authors.forename: N
authors.initials: N
authors.lastname: van As
authors.affiliation: The Christie NHS Foundation Trust and Manchester Cancer Research Centre, University of Manchester, Manchester Academic Health Sciences Centre, UK.
authors.forename: M
authors.initials: M
authors.lastname: van Herk
authors.affiliation: Sunnybrook Health Sciences Centre, University of Toronto, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Vesprini
authors.affiliation: University Medical Center Utrecht, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: van der Voort van Zyp
authors.affiliation: Royal Marsden Hospital, UK.
authors.forename: A
authors.initials: A
authors.lastname: Tree
authors.affiliation: The Christie NHS Foundation Trust and Manchester Cancer Research Centre, University of Manchester, Manchester Academic Health Sciences Centre, UK. Electronic address: Ananya.choudhury@christie.nhs.uk.
authors.forename: A
authors.initials: A
authors.lastname: Choudhury
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009038:Motion; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods
keywords: Adaptive radiotherapy; IGRT; MR-Linac; MRI; Prostate