AUTHOR=Bryant John M. , Sim Austin J. , Feygelman Vladimir , Latifi Kujtim , Rosenberg Stephen A. 

TITLE=Adaptive hypofractionted and stereotactic body radiotherapy for lung tumors with real-time MRI guidance

JOURNAL=Frontiers in Oncology

VOLUME=13

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1061854

DOI=10.3389/fonc.2023.1061854

ISSN=2234-943X

ABSTRACT=<p>The treatment of central and ultracentral lung tumors with radiotherapy remains an ongoing clinical challenge. The risk of Grade 5 toxicity with ablative radiotherapy doses to these high-risk regions is significant as shown in recent prospective studies. Magnetic resonance (MR) image-guided adaptive radiotherapy (MRgART) is a new technology and may allow the delivery of ablative radiotherapy to these high-risk regions safely. MRgART is able to achieve this by utilizing small treatment margins, real-time gating/tracking and on-table plan adaptation to maintain dose to the tumor but limit dose to critical structures. The process of MRgART is complex and has nuances and challenges for the treatment of lung tumors. We outline the critical steps needed for appropriate delivery of MRgART for lung tumors safely and effectively.</p>