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Author Spotlight: Improving Radiation Therapy Access with Radiation Planning Assistant
Published on: October 6, 2023
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Adaptive radiotherapy, promises and pitfalls.
Ariane Lapierre1, Pierre Blanchard2
1Département de radiothérapie oncologie, centre hospitalier universitaire Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Université de Lyon, 69000 Lyon, France.
Summary
Adaptive radiotherapy adjusts radiation treatment to patient changes, optimizing dose delivery and tumor targeting. While showing dosimetric benefits, its clinical advantages and cost-effectiveness require further investigation.
Area of Science:
- Radiation Oncology
- Medical Imaging
- Cancer Treatment
Background:
- Adaptive radiotherapy (ART) dynamically adjusts radiation treatments based on anatomical and tumor volume changes during therapy.
- It aims to optimize dose distribution, maintain tumor coverage, and protect organs at risk.
- ART can be implemented offline (between fractions), online (immediately before fractions), or in real-time during treatment fractions.
Purpose of the Study:
- To review the principles, advancements, and current status of adaptive radiotherapy.
- To highlight the technical developments enabling online adaptive radiotherapy.
- To discuss the demonstrated benefits and limitations of adaptive radiotherapy.
Main Methods:
- Review of adaptive radiotherapy techniques and technological advancements.
- Analysis of dosimetric benefits and clinical outcomes reported in the literature.
- Discussion of implementation challenges, including time, logistics, and cost-efficiency.
Main Results:
- Linear accelerators with integrated CT or MRI enable online adaptive radiotherapy.
- ART has shown dosimetric advantages, including improved target coverage and organ-at-risk sparing.
- Robust clinical data on toxicity reduction and tumor control improvement are still limited across various disease sites.
Conclusions:
- Online adaptive radiotherapy systems have advanced significantly, facilitating wider adoption.
- While dosimetric benefits are evident, further research is needed to confirm clinical benefits and cost-effectiveness.
- Successful implementation requires careful planning, resource allocation, and addressing logistical challenges.
