Hijab Adham, Tocco Boris, Hanson Ian, Meijer Hanneke, Nyborg Christina Junker, Bertelsen Anders Smedegaard, Smeenk Robert Jan, Smith Gillian, Michalski Jeff, Baumann Brian C, Hafeez Shaista
Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, United Kingdom.
Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, London, United Kingdom.
Front Oncol. 2021 Feb 25;11:637591. doi: 10.3389/fonc.2021.637591. eCollection 2021.
Radiotherapy has an important role in the curative and palliative treatment settings for bladder cancer. As a target for radiotherapy the bladder presents a number of technical challenges. These include poor tumor visualization and the variability in bladder size and position both between and during treatment delivery. Evidence favors the use of magnetic resonance imaging (MRI) as an important means of tumor visualization and local staging. The availability of hybrid systems incorporating both MRI scanning capabilities with the linear accelerator (MR-Linac) offers opportunity for in-room and real-time MRI scanning with ability of plan adaption at each fraction while the patient is on the treatment couch. This has a number of potential advantages for bladder cancer patients. In this article, we examine the technical challenges of bladder radiotherapy and explore how magnetic resonance (MR) guided radiotherapy (MRgRT) could be leveraged with the aim of improving bladder cancer patient outcomes. However, before routine clinical implementation robust evidence base to establish whether MRgRT translates into improved patient outcomes should be ascertained.
放射治疗在膀胱癌的根治性和姑息性治疗中发挥着重要作用。作为放射治疗的靶区，膀胱存在一些技术挑战。这些挑战包括肿瘤可视化不佳以及治疗期间和不同治疗之间膀胱大小和位置的变异性。有证据支持使用磁共振成像（MRI）作为肿瘤可视化和局部分期的重要手段。结合MRI扫描功能与直线加速器的混合系统（MR-Linac）的出现，为在患者躺在治疗床上时进行室内实时MRI扫描并在每次分割时进行计划调整提供了机会。这对膀胱癌患者有许多潜在优势。在本文中，我们研究了膀胱放射治疗的技术挑战，并探讨如何利用磁共振（MR）引导放射治疗（MRgRT）以改善膀胱癌患者的治疗效果。然而，在常规临床应用之前，应确定是否有强有力的证据基础来证实MRgRT是否能转化为改善患者的治疗效果。
