Adaptive Radiation Therapy (ART) Strategies and Technical Considerations: A State of the ART Review From NRG Oncology. Int J Radiat Oncol Biol Phys 2021 Mar 15;109(4):1054-1075
Date
01/21/2021Pubmed ID
33470210Pubmed Central ID
PMC8290862DOI
10.1016/j.ijrobp.2020.10.021Scopus ID
2-s2.0-85100531472 (requires institutional sign-in at Scopus site) 107 CitationsAbstract
The integration of adaptive radiation therapy (ART), or modifying the treatment plan during the treatment course, is becoming more widely available in clinical practice. ART offers strong potential for minimizing treatment-related toxicity while escalating or de-escalating target doses based on the dose to organs at risk. Yet, ART workflows add complexity into the radiation therapy planning and delivery process that may introduce additional uncertainties. This work sought to review presently available ART workflows and technological considerations such as image quality, deformable image registration, and dose accumulation. Quality assurance considerations for ART components and minimum recommendations are described. Personnel and workflow efficiency recommendations are provided, as is a summary of currently available clinical evidence supporting the implementation of ART. Finally, to guide future clinical trial protocols, an example ART physician directive and a physics template following standard NRG Oncology protocol is provided.
Author List
Glide-Hurst CK, Lee P, Yock AD, Olsen JR, Cao M, Siddiqui F, Parker W, Doemer A, Rong Y, Kishan AU, Benedict SH, Li XA, Erickson BA, Sohn JW, Xiao Y, Wuthrick EAuthor
Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
BrachytherapyClinical Trials as Topic
Humans
Organs at Risk
Quality Assurance, Health Care
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Image-Guided
Tomography, X-Ray Computed
Workflow