About this Research Topic
Up to half of men dying of prostate cancer (PCa) initially presented with localized disease, for which external beam radiotherapy (EBRT) is a standard of care. Even for men cured of their disease, all incur at least temporary quality of life impact from dose to adjacent structures involved in urinary, bowel and sexual function. To reduce harm from disease and treatment, focus in EBRT research has long focused on pre-therapy optimization of target delineation and dose delivery. However, changes in target deformation & size, adjacent organ position (ie: bladder, rectum) and even potentially intra-prostatic dominant disease occur during therapy. These changes may affect therapeutic ratio of EBRT, particularly increasingly hypofractionated regimens where impact of accuracy is magnified. Recognition of this has led to surging interest in CT-based and MR-based ‘adaptive’ therapy solutions, wherein on-board imaging can be used to re-plan EBRT according to realtime daily changes in target or adjacent organ anatomy.
Multiple commercially available MRI-based (Elekta Unity, Viewray MRIdian) and CT-based (Varian Ethos) adaptive therapy capable linear accelerators are now in clinical use. While clinical trial data are yet maturing it is clear their adoption have moved beyond simple feasibility assessment and into vigorous and creative studies into reducing treatment toxicity and potentially disease relapse in localized prostate cancer. At this critical point in their evolution and adoption, the goal of this Research Topic is to present a forum for critical assessments of their current and future directions, which ideally would guide future trial designs to discern clinical benefit for this new technology.
Topics of interest include:
-Workflow QA and optimization of adaptive therapy platforms for localized PCa
-Financial impact on patients, providers and/or health systems/insurers of adaptive therapy use in PCa
-Comparative efficacy analyses of outcome or toxicity of adaptive therapy based therapy in PCa
-Use of MR-based linac for identifying and targeting intra-prostatic dominant lesions
-Technical and clinical reports on feasibility and potential benefits of post-prostatectomy adaptive EBRT
-Use of auto-segmentation, planning and other AI-based augmentations of adaptive therapy workflow
-Staff training in use of adaptive therapy workflows
-Integration of brachytherapy into adaptive therapy EBRT regimens for PCa
-Novel biologic evaluation approaches to treatment response on therapy using MR-based linac in PCa
Please note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.
Multiple commercially available MRI-based (Elekta Unity, Viewray MRIdian) and CT-based (Varian Ethos) adaptive therapy capable linear accelerators are now in clinical use. While clinical trial data are yet maturing it is clear their adoption have moved beyond simple feasibility assessment and into vigorous and creative studies into reducing treatment toxicity and potentially disease relapse in localized prostate cancer. At this critical point in their evolution and adoption, the goal of this Research Topic is to present a forum for critical assessments of their current and future directions, which ideally would guide future trial designs to discern clinical benefit for this new technology.
Topics of interest include:
-Workflow QA and optimization of adaptive therapy platforms for localized PCa
-Financial impact on patients, providers and/or health systems/insurers of adaptive therapy use in PCa
-Comparative efficacy analyses of outcome or toxicity of adaptive therapy based therapy in PCa
-Use of MR-based linac for identifying and targeting intra-prostatic dominant lesions
-Technical and clinical reports on feasibility and potential benefits of post-prostatectomy adaptive EBRT
-Use of auto-segmentation, planning and other AI-based augmentations of adaptive therapy workflow
-Staff training in use of adaptive therapy workflows
-Integration of brachytherapy into adaptive therapy EBRT regimens for PCa
-Novel biologic evaluation approaches to treatment response on therapy using MR-based linac in PCa
Please note: manuscripts consisting solely of bioinformatics or computational analysis of public genomic or transcriptomic databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) are out of scope for this section and will not be accepted as part of this Research Topic.
Keywords: MR Linac, Unity, MRIdian, Prostate Cancer, SBRT, SAbR, MRgRT, Ethos, Adaptive therapy
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.
