Chetty Indrin J, Doemer Anthony J, Dolan Jennifer L, Kim Joshua P, Cunningham Justine M, Dragovic Jadranka, Feldman Aharon, Walker Eleanor M, Elshaikh Mohamed, Adil Khaled, Movsas Benjamin, Parikh Parag J
Henry Ford Cancer Institute, Detroit, Michigan.
Henry Ford Cancer Institute, Detroit, Michigan.
Int J Radiat Oncol Biol Phys. 2022 Dec 1;114(5):950-967. doi: 10.1016/j.ijrobp.2022.07.027. Epub 2022 Jul 25.
Early clinical results on the application of magnetic resonance imaging (MRI) coupled with a linear accelerator to deliver Magnetic Resonance-guided Radiation Therapy (MRgRT) have demonstrated feasibility for safe delivery of stereotactic body radiation therapy in treatment of oligometastatic disease. Here, we set out to review the clinical evidence and challenges associated with MRgRT in this setting.
We performed a systematic review of the literature pertaining to clinical experiences and trials on the use of MRgRT primarily for the treatment of oligometastatic cancers. We reviewed the opportunities and challenges associated with the use of MRgRT.
Benefits of MRgRT pertaining to superior soft-tissue contrast, real-time imaging and gating, and online adaptive radiation therapy facilitate safe and effective dose escalation to oligometastatic tumors while simultaneously sparing surrounding healthy tissues. Challenges concerning further need for clinical evidence and technical considerations related to planning, delivery, quality assurance of hypofractionated doses, and safety in the MRI environment must be considered.
The promising early indications of safety and effectiveness of MRgRT for stereotactic body radiation therapy-based treatment of oligometastatic disease in multiple treatment locations should lead to further clinical evidence to demonstrate the benefit of this technology.
关于应用磁共振成像（MRI）结合直线加速器进行磁共振引导放射治疗（MRgRT）的早期临床结果已证明，在治疗寡转移疾病中安全实施立体定向体部放射治疗具有可行性。在此，我们着手回顾在这种情况下与MRgRT相关的临床证据和挑战。
我们对主要用于治疗寡转移癌的MRgRT的临床经验和试验相关文献进行了系统回顾。我们回顾了与使用MRgRT相关的机遇和挑战。
MRgRT的优势在于卓越的软组织对比度、实时成像和门控以及在线自适应放射治疗，有助于在保护周围健康组织的同时，安全有效地增加寡转移肿瘤的剂量。必须考虑与进一步的临床证据需求以及与计划、实施、低分割剂量的质量保证和MRI环境中的安全性相关的技术考量等挑战。
MRgRT在多个治疗部位基于立体定向体部放射治疗治疗寡转移疾病的安全性和有效性的早期迹象令人鼓舞，应能产生更多临床证据以证明该技术的益处。
