Abstract
BackgroundIn recent years, we have seen the incorporation of magnetic resonance imaging (MRI) simulators into radiotherapy centres and the emergence of the new technology of MR linacs. However, the significant health care resources associated with this advanced technology impact immediate widespread use and availability. There are currently limited studies to demonstrate the clinical effectiveness and inform decision-making on the use of MRI in radiotherapy. The objective of this scoping review is to identify and map the existing evidence surrounding the clinical implementation of MRI-guided radiotherapy in patients with breast cancer. It also aims to identify challenges and knowledge gaps in the literature.MethodsWe will perform a comprehensive search in MEDLINE and EMBASE databases from January 2010 onwards. Grey literature sources will include the WHO International Clinical Trials Registry Platform. We will include systematic reviews, randomised and non-randomised controlled studies published in English. Literature should examine the use of magnetic resonance imaging-guided radiotherapy in adults with breast cancer, regardless of cancer stage or severity. Two reviewers will independently screen all titles, abstracts and full-text reports. Data will be extracted and summarised using qualitative (e.g. content and thematic analysis) methods and presented in tables.DiscussionThe results from this review will consolidate the evidence surrounding MRI-guided radiotherapy for breast cancer, contributing to the development and optimisation of patient selection, simulation, planning, treatment delivery, quality assurance and research, to help improve patient outcomes, cancer care and treatment for women with breast cancer.Systematic review registrationThe protocol is available on Open Science Framework at DOI https://doi.org/10.17605/OSF.IO/8TEV6
Highlights
In recent years, we have seen the incorporation of magnetic resonance imaging (MRI) simulators into radiotherapy centres and the emergence of the new technology of Magnetic resonance (MR) linacs
The primary aim of this review is to describe the state of the peer-reviewed literature on key aspects of the radiotherapy chain including simulation, tumour delineation, planning, treatment delivery and quality assurance for MRI-guided breast radiotherapy
This research will be guided by the following research question: What is the range of existing evidence surrounding the clinical implementation of MRI-guided radiotherapy in patients with breast cancer?
Summary
We have seen the incorporation of magnetic resonance imaging (MRI) simulators into radiotherapy centres and the emergence of the new technology of MR linacs. There are currently limited studies to demonstrate the clinical effectiveness and inform decision-making on the use of MRI in radiotherapy. The objective of this scoping review is to identify and map the existing evidence surrounding the clinical implementation of MRI-guided radiotherapy in patients with breast cancer. The long fractionation time of whole breast irradiation can be a burden to patients, and this has led to hypo-fractionated schemes such as 42.5 Gy/16[4] and 26 Gy/5 [5], which have comparable patient outcomes An alternative to this is accelerated partial breast irradiation (APBI), which delivers a higher dose of radiotherapy to a limited volume of tissue, with an even shorter course duration. APBI may be considered for selected cases of lower-risk disease [11, 12] where the tumour bed can be accurately localised
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