Online Adaptive Radiation Therapy.

Area of Science:

• Medical Physics
• Radiation Oncology
• Image-Guided Therapy

Background:

• Current radiation therapy relies on static imaging, leading to suboptimal treatment as patient anatomy changes.
• Existing in-room imaging is often limited to rigid matching, failing to account for anatomical deformations.
• This necessitates advancements to maintain treatment accuracy throughout the patient's therapy course.

Purpose of the Study:

• To review the evolving paradigm of Adaptive Radiation Therapy (ART).
• To highlight ART's potential to address limitations in conventional radiation therapy.
• To explore the components and clinical implementation of ART across various treatment sites.

Main Methods:

• Review of existing studies and clinical implementations of ART.
• Analysis of ART's reliance on in-room imaging, deformable image registration, and automatic recontouring.
• Evaluation of plan reoptimization, dose calculation, and quality assurance in ART.

Main Results:

• ART accounts for anatomical and physiological changes during treatment.
• ART enables more accurate disease targeting by adapting treatment plans.
• Several centers have initiated clinical implementation of online ART, demonstrating its feasibility.

Conclusions:

• Adaptive Radiation Therapy represents a significant advancement over static treatment planning.
• ART's integrated components offer a more precise and effective approach to radiation oncology.
• Further exploration and implementation of ART are crucial for optimizing cancer treatment outcomes.