Adaptive Radiation Therapy in the Treatment of Lung Cancer: An Overview of the Current State of the Field

Lung cancer treatment is constantly evolving due to technological advances in the delivery of radiation therapy. Adaptive radiation therapy (ART) allows for modification of a treatment plan with the goal of improving the dose distribution to the patient due to anatomic or physiologic deviations from...

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Autores principales:	Huzaifa Piperdi, Daniella Portal, Shane S. Neibart, Ning J. Yue, Salma K. Jabbour, Meral Reyhan
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	adaptive radiation therapy (ART) adaptive planning non-small cell lung cancer small cell lung cancer (SCLC) lung cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/c621c7d25c6840f1926fd0042a8282a2
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spelling	oai:doaj.org-article:c621c7d25c6840f1926fd0042a8282a22021-12-01T11:25:53ZAdaptive Radiation Therapy in the Treatment of Lung Cancer: An Overview of the Current State of the Field2234-943X10.3389/fonc.2021.770382https://doaj.org/article/c621c7d25c6840f1926fd0042a8282a22021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.770382/fullhttps://doaj.org/toc/2234-943XLung cancer treatment is constantly evolving due to technological advances in the delivery of radiation therapy. Adaptive radiation therapy (ART) allows for modification of a treatment plan with the goal of improving the dose distribution to the patient due to anatomic or physiologic deviations from the initial simulation. The implementation of ART for lung cancer is widely varied with limited consensus on who to adapt, when to adapt, how to adapt, and what the actual benefits of adaptation are. ART for lung cancer presents significant challenges due to the nature of the moving target, tumor shrinkage, and complex dose accumulation because of plan adaptation. This article presents an overview of the current state of the field in ART for lung cancer, specifically, probing topics of: patient selection for the greatest benefit from adaptation, models which predict who and when to adapt plans, best timing for plan adaptation, optimized workflows for implementing ART including alternatives to re-simulation, the best radiation techniques for ART including magnetic resonance guided treatment, algorithms and quality assurance, and challenges and techniques for dose reconstruction. To date, the clinical workflow burden of ART is one of the major reasons limiting its widespread acceptance. However, the growing body of evidence demonstrates overwhelming support for reduced toxicity while improving tumor dose coverage by adapting plans mid-treatment, but this is offset by the limited knowledge about tumor control. Progress made in predictive modeling of on-treatment tumor shrinkage and toxicity, optimizing the timing of adaptation of the plan during the course of treatment, creating optimal workflows to minimize staffing burden, and utilizing deformable image registration represent ways the field is moving toward a more uniform implementation of ART.Huzaifa PiperdiDaniella PortalShane S. NeibartNing J. YueSalma K. JabbourSalma K. JabbourMeral ReyhanFrontiers Media S.A.articleadaptive radiation therapy (ART)adaptive planningnon-small cell lung cancersmall cell lung cancer (SCLC)lung cancerNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	adaptive radiation therapy (ART) adaptive planning non-small cell lung cancer small cell lung cancer (SCLC) lung cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	adaptive radiation therapy (ART) adaptive planning non-small cell lung cancer small cell lung cancer (SCLC) lung cancer Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Huzaifa Piperdi Daniella Portal Shane S. Neibart Ning J. Yue Salma K. Jabbour Salma K. Jabbour Meral Reyhan Adaptive Radiation Therapy in the Treatment of Lung Cancer: An Overview of the Current State of the Field
description	Lung cancer treatment is constantly evolving due to technological advances in the delivery of radiation therapy. Adaptive radiation therapy (ART) allows for modification of a treatment plan with the goal of improving the dose distribution to the patient due to anatomic or physiologic deviations from the initial simulation. The implementation of ART for lung cancer is widely varied with limited consensus on who to adapt, when to adapt, how to adapt, and what the actual benefits of adaptation are. ART for lung cancer presents significant challenges due to the nature of the moving target, tumor shrinkage, and complex dose accumulation because of plan adaptation. This article presents an overview of the current state of the field in ART for lung cancer, specifically, probing topics of: patient selection for the greatest benefit from adaptation, models which predict who and when to adapt plans, best timing for plan adaptation, optimized workflows for implementing ART including alternatives to re-simulation, the best radiation techniques for ART including magnetic resonance guided treatment, algorithms and quality assurance, and challenges and techniques for dose reconstruction. To date, the clinical workflow burden of ART is one of the major reasons limiting its widespread acceptance. However, the growing body of evidence demonstrates overwhelming support for reduced toxicity while improving tumor dose coverage by adapting plans mid-treatment, but this is offset by the limited knowledge about tumor control. Progress made in predictive modeling of on-treatment tumor shrinkage and toxicity, optimizing the timing of adaptation of the plan during the course of treatment, creating optimal workflows to minimize staffing burden, and utilizing deformable image registration represent ways the field is moving toward a more uniform implementation of ART.
format	article
author	Huzaifa Piperdi Daniella Portal Shane S. Neibart Ning J. Yue Salma K. Jabbour Salma K. Jabbour Meral Reyhan
author_facet	Huzaifa Piperdi Daniella Portal Shane S. Neibart Ning J. Yue Salma K. Jabbour Salma K. Jabbour Meral Reyhan
author_sort	Huzaifa Piperdi
title	Adaptive Radiation Therapy in the Treatment of Lung Cancer: An Overview of the Current State of the Field
title_short	Adaptive Radiation Therapy in the Treatment of Lung Cancer: An Overview of the Current State of the Field
title_full	Adaptive Radiation Therapy in the Treatment of Lung Cancer: An Overview of the Current State of the Field
title_fullStr	Adaptive Radiation Therapy in the Treatment of Lung Cancer: An Overview of the Current State of the Field
title_full_unstemmed	Adaptive Radiation Therapy in the Treatment of Lung Cancer: An Overview of the Current State of the Field
title_sort	adaptive radiation therapy in the treatment of lung cancer: an overview of the current state of the field
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/c621c7d25c6840f1926fd0042a8282a2
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Adaptive Radiation Therapy in the Treatment of Lung Cancer: An Overview of the Current State of the Field

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