Adaptive radiotherapy for breast cancer.

Area of Science:

• Oncology
• Radiotherapy
• Medical Physics

Background:

• Breast cancer radiotherapy aims to balance oncological control with reduced treatment toxicity.
• Anatomical variations during treatment can impact radiotherapy effectiveness and safety.
• Adaptive radiotherapy (ART) offers a solution by integrating real-time anatomical data into treatment planning.

Purpose of the Study:

• To review the current applications of MR-guided and CT-guided adaptive radiotherapy (ART) in breast cancer.
• To discuss the advantages and challenges of implementing ART in diverse clinical scenarios.
• To highlight the potential of ART in improving treatment outcomes and reducing toxicity.

Main Methods:

• Review of existing literature on MR-guided and CT-guided ART for breast cancer.
• Analysis of ART application in neoadjuvant/adjuvant partial breast irradiation, whole breast, chest wall, and regional nodal irradiation.
• Discussion of benefits such as smaller target volumes and improved organ at risk (OAR) sparing.

Main Results:

• ART enables adjustments to radiotherapy plans based on observed anatomical changes during treatment.
• Potential for reduced acute and late toxicities due to optimized target volumes and OAR sparing.
• ART can be applied across various breast cancer treatment scenarios, including partial breast, whole breast, and nodal irradiation.

Conclusions:

• Routine clinical implementation of ART in breast cancer radiotherapy holds significant promise.
• ART can lead to enhanced oncological outcomes and decreased treatment-related toxicities.
• Further research and standardization are needed to fully exploit the potential of guided ART techniques.