Faculty Collaboration Database

Evolution of Image Guidance and Adaptive Radiation Therapy for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2025 Jul 15;122(4):968-975

Date

06/27/2025

Pubmed ID

40571371

DOI

10.1016/j.ijrobp.2024.12.011

Scopus ID

2-s2.0-105007867175 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

Radiation therapy (RT) has played a pivotal role in managing prostate cancer over the past 5 decades, undergoing significant transformations to optimize therapeutic efficacy and minimize toxicity. Advances in radiobiologic understanding and technological innovation have shifted RT practices, enabling precision in dose delivery and enhanced protection of adjacent normal tissues. This review examines the evolution of RT techniques, from early 2-dimensional planning to modern adaptive approaches that incorporate real-time imaging adjustments. With the introduction of 3-dimensional conformal RT, intensity modulated RT, volumetric modulated arc therapy, and image guided techniques, the safety and efficacy of RT have improved dramatically, reducing gastrointestinal and genitourinary toxicities and expanding its indications to include localized, recurrent, and metastatic prostate cancer. Today, online adaptive RT, supported using computed tomography and magnetic resonance imaging guidance, allows for precise dose modifications that align with daily anatomic changes, thus advancing the therapeutic ratio further. This review details these advancements, highlighting their impact on local control, patient outcomes, and future implications for RT in prostate cancer treatment.

Author List

Patel RK, Lee J, Patel M, Zaorsky NG, Zuhour R, Kashani R, Henke LE, Spratt DE, Price AT, Jia AY

Author

Rohan K. Patel MPH, MD Assistant Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Humans
Magnetic Resonance Imaging
Male
Organs at Risk
Prostatic Neoplasms
Radiation Injuries
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Conformal
Radiotherapy, Image-Guided
Radiotherapy, Intensity-Modulated
Tomography, X-Ray Computed