Adaptive Radiation Therapy (ART) Strategies and Technical Considerations: A State of the ART Review From NRG Oncology

Carri K. Glide-Hurst, Percy Lee, Adam D. Yock, Jeffrey R. Olsen, Minsong Cao, Farzan Siddiqui, William Parker, Anthony Doemer, Yi Rong, Amar U. Kishan, Stanley H. Benedict, X. Allen Li, Beth A. Erickson, Jason W. Sohn, Ying Xiao, Evan Wuthrick

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations


The integration of adaptive radiation therapy (ART), or modifying the treatment plan during the treatment course, is becoming more widely available in clinical practice. ART offers strong potential for minimizing treatment-related toxicity while escalating or de-escalating target doses based on the dose to organs at risk. Yet, ART workflows add complexity into the radiation therapy planning and delivery process that may introduce additional uncertainties. This work sought to review presently available ART workflows and technological considerations such as image quality, deformable image registration, and dose accumulation. Quality assurance considerations for ART components and minimum recommendations are described. Personnel and workflow efficiency recommendations are provided, as is a summary of currently available clinical evidence supporting the implementation of ART. Finally, to guide future clinical trial protocols, an example ART physician directive and a physics template following standard NRG Oncology protocol is provided.

Original languageEnglish (US)
Pages (from-to)1054-1075
Number of pages22
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number4
StatePublished - Mar 15 2021

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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