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© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Simple Summary

Normal tissue toxicities in head and neck cancer persist as a cause of decreased quality of life and are associated with poorer treatment outcomes. The aim of this article is to review organ at risk (OAR) sparing approaches available in MR-guided adaptive radiotherapy and present future developments which hope to improve treatment outcomes. Increasing the spatial conformity of dose distributions in radiotherapy is an important first step in reducing normal tissue toxicities, and MR-guided treatment devices presents a new opportunity to use biological information to drive treatment decisions on a personalized basis.

Abstract

MR-linac devices offer the potential for advancements in radiotherapy (RT) treatment of head and neck cancer (HNC) by using daily MR imaging performed at the time and setup of treatment delivery. This article aims to present a review of current adaptive RT (ART) methods on MR-Linac devices directed towards the sparing of organs at risk (OAR) and a view of future adaptive techniques seeking to improve the therapeutic ratio. This ratio expresses the relationship between the probability of tumor control and the probability of normal tissue damage and is thus an important conceptual metric of success in the sparing of OARs. Increasing spatial conformity of dose distributions to target volume and OARs is an initial step in achieving therapeutic improvements, followed by the use of imaging and clinical biomarkers to inform the clinical decision-making process in an ART paradigm. Pre-clinical and clinical findings support the incorporation of biomarkers into ART protocols and investment into further research to explore imaging biomarkers by taking advantage of the daily MR imaging workflow. A coherent understanding of this road map for RT in HNC is critical for directing future research efforts related to sparing OARs using image-guided radiotherapy (IGRT).

Details

Title
MR-Guided Adaptive Radiotherapy for OAR Sparing in Head and Neck Cancers
Author
Mulder, Samuel L 1   VIAFID ORCID Logo  ; Heukelom, Jolien 2 ; McDonald, Brigid A 1 ; Lisanne Van Dijk 2 ; Wahid, Kareem A 1 ; Sanders, Keith 1 ; Salzillo, Travis C 1   VIAFID ORCID Logo  ; Hemmati, Mehdi 3 ; Schaefer, Andrew 3 ; Fuller, Clifton D 1   VIAFID ORCID Logo 

 Department of Radiation Oncology, The University of Texas at MD Anderson Cancer Center, Houston, TX 77030, USA; [email protected] (B.A.M.); [email protected] (K.A.W.); [email protected] (K.S.); [email protected] (T.C.S.); [email protected] (C.D.F.) 
 Department of Radiation Oncology, Erasmus Medical Center, 3015 GD Rotterdam, The Netherlands; [email protected] (J.H.); [email protected] (L.V.D.) 
 Department of Computational and Applied Mathematics, Rice University, Houston, TX 77005, USA; [email protected] (M.H.); [email protected] (A.S.) 
First page
1909
Publication year
2022
Publication date
2022
Publisher
MDPI AG
e-ISSN
20726694
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2652960377
Copyright
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.