Murray Julia, Tree Alison C
The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London UK.
Clin Transl Radiat Oncol. 2019 Apr 1;18:68-73. doi: 10.1016/j.ctro.2019.03.006. eCollection 2019 Sep.
External beam radiotherapy for prostate cancer is an optimal treatment choice for men with localised prostate cancer and is associated with long term disease control in most patients. Image-guided prostate radiotherapy is standard of care, however, current techniques can include invasive procedures with imaging of poor soft tissue resolution, thus limiting accuracy. MRI is the imaging of choice for local prostate cancer staging and in radiotherapy planning has been shown to reduce target volume and reduce inter-observer prostate contouring variability. The ultimate aim would be to have a MR-only workflow for prostate radiotherapy. Within this article, we discuss these opportunities and challenges, relevant due to the increasing availability of MR-guided radiotherapy. Prospective multi-centre studies are underway to determine the feasibility of MR-guided prostate radiotherapy and daily adaptive replanning. In parallel, development and adaptation of the existing radiotherapy multidisciplinary workforce is essential to enable an efficient and effective MR-guided radiotherapy workflow. This technology potentially provides us with the anatomical and biological information to further improve outcomes for our patients.
前列腺癌的外照射放疗是局限性前列腺癌男性患者的最佳治疗选择，且在大多数患者中与长期疾病控制相关。图像引导的前列腺放疗是标准治疗方法，然而，当前技术可能包括软组织分辨率较差的成像的侵入性程序，从而限制了准确性。MRI是局部前列腺癌分期的首选成像方法，并且在放疗计划中已显示可减少靶体积并降低观察者间前列腺轮廓勾画的变异性。最终目标是实现仅使用MR的前列腺放疗工作流程。在本文中，我们讨论了这些机遇和挑战，由于MR引导放疗的可用性不断提高，这些机遇和挑战具有相关性。正在进行前瞻性多中心研究，以确定MR引导的前列腺放疗和每日适应性重新计划的可行性。与此同时，对现有放疗多学科工作人员进行发展和调整对于实现高效有效的MR引导放疗工作流程至关重要。这项技术有可能为我们提供解剖学和生物学信息，以进一步改善患者的治疗效果。
