Abstract
Online MRI-guided radiotherapy (MRgRT) is one of the most recent technological advances in radiotherapy. MRgRT permits the visualization of tumorous and healthy tissue while the patient is on the treatment table and online daily plan adaptations following the observed anatomical changes. In the context of rectal cancer, online MRgRT is a very promising modality due to the pronounced geographical variability of tumor tissues and the surrounding healthy tissues. This current paper will discuss the possible applications of online MRgRT, in particular, in terms of radiotherapy dose escalation and response prediction in organ preservation approaches for rectal cancer.
Highlights
Neoadjuvantradiotherapy (NCRT) represents the reference standard in the treatment of locally advanced rectal cancer (LARC), primarily aiming to reduce local recurrence rates after surgery [1]
This review aims to present and discuss opportunities with online MRI-guided radiotherapy (MRgRT) in the treatment of rectal cancer
Reduced margins and daily adaptation of treatment fields lead to a reduced spread of the dose in the surrounding healthy structures, such as the surrounding uninvolved rectal wall, the small bowel, the bladder, and the anal sphincter, potentially resulting in less radiotherapyrelated short- and long-time side effects
Summary
Online MRI-guided radiotherapy (MRgRT) is one of the most recent technological advances in radiotherapy. MRgRT permits the visualization of tumorous and healthy tissue while the patient is on the treatment table and online daily plan adaptations following the observed anatomical changes. In the context of rectal cancer, online MRgRT is a very promising modality due to the pronounced geographical variability of tumor tissues and the surrounding healthy tissues. This current paper will discuss the possible applications of online MRgRT, in particular, in terms of radiotherapy dose escalation and response prediction in organ preservation approaches for rectal cancer
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