MRI-Guided Radiation Therapy for Prostate Cancer: The Next Frontier in Ultrahypofractionation
Open Access
Abstract
Technological advances in MRI-guided radiation therapy (MRIgRT) have improved real-time visualization of the prostate and its surrounding structures over CT-guided radiation therapy. Seminal studies have demonstrated safe dose escalation achieved through ultrahypofractionation with MRIgRT due to planning target volume (PTV) margin reduction and treatment gating. On-table adaptation with MRI-based technologies can also incorporate real-time changes in target shape and volume and can reduce high doses of radiation to sensitive surrounding structures that may move into the treatment field. Ongoing clinical trials seek to refine ultrahypofractionated radiotherapy treatments for prostate cancer using MRIgRT. Though these studies have the potential to demonstrate improved biochemical control and reduced side effects, limitations concerning patient treatment times and operational workflows may preclude wide adoption of this technology outside of centers of excellence. In this review, we discuss the advantages and limitations of MRIgRT for prostate cancer, as well as clinical trials testing the efficacy and toxicity of ultrafractionation in patients with localized or post-prostatectomy recurrent prostate cancer.Keywords
Funding Information
- Bristol Myers Squibb Foundation (20224794)
This publication has 73 references indexed in Scilit:
- Randomized Phase III Noninferiority Study Comparing Two Radiotherapy Fractionation Schedules in Patients With Low-Risk Prostate CancerJournal of Clinical Oncology, 2016
- Radiotherapy Boost for the Dominant Intraprostatic Cancer Lesion—A Systematic Review and Meta-AnalysisClinical Genitourinary Cancer, 2016
- Automatic Substitute Computed Tomography Generation and Contouring for Magnetic Resonance Imaging (MRI)-Alone External Beam Radiation Therapy From Standard MRI SequencesInternational Journal of Radiation Oncology - Biology - Physics (IJROBP), 2015
- Prostate Cancer: assessing the effects of androgen-deprivation therapy using quantitative diffusion-weighted and dynamic contrast-enhanced MRIEuropean Radiology, 2015
- A voxel-based investigation for MRI-only radiotherapy of the brain using ultra short echo timesPhysics in Medicine & Biology, 2014
- The ViewRay System: Magnetic Resonance–Guided and Controlled RadiotherapySeminars in Radiation Oncology, 2014
- Escalated-dose versus control-dose conformal radiotherapy for prostate cancer: long-term results from the MRC RT01 randomised controlled trialThe Lancet Oncology, 2014
- A criterion for the reliable use of MRI-only radiotherapyRadiation Oncology, 2014
- The effect of concurrent androgen deprivation and 3D conformal radiotherapy on prostate volume and clinical organ doses during treatment for prostate cancerBritish Journal of Radiology, 2009
- Effect of bladder filling on doses to prostate and organs at risk: a treatment planning studyJournal of Applied Clinical Medical Physics, 2007