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MRg-A-SBRT: A New Innovation in Cancer Research

Authored by Rohith Karthik


Cancer, often regarded as one of the most formidable adversaries of human health, has long cast its ominous shadow over individuals and communities worldwide. Its relentless progression and often devastating consequences have propelled cancer research and treatment to the forefront of medical science. In recent years, remarkable advancements have emerged in the field of cancer treatment, ushering in a new era of hope and promise for patients and their families. These breakthroughs have redefined the landscape of cancer care, offering novel therapeutic approaches and innovative technologies that are transforming the way we combat this complex and multifaceted disease. 


One such breakthrough was the discovery of SBRT (Stereotactic Body Radiation Therapy). The development of SBRT began in the early 1990s and was a significant discovery at the time. SBRT uses high doses of radiation via multiple radiation beams to deliver an accurate dosage of radiation to a specific tumorous location [1]. This treatment, in theory, would be able to reduce radioactive effects to other parts of the body and only target the cancerous locations. In reality, this is far from the truth. The amount of radiation that may be safely delivered to a particular location may not be as effective if the cancer is close to a sensitive structure such as the spinal cord or the bowel. Another disadvantage to the SBRT developed in the ‘90s is that this technique is only suitable for small, well-defined tumors that can be seen on imaging such as CT or MRI scans [2]. Medical professionals have begun combining SBRT with cutting-edge imaging equipment such as Axesse, and CyberKnife robotic radiosurgery system that can monitor tumor movements in real time. lungs, spine, liver, neck, lymph nodes or other soft tissues [3]. Unfortunately, the position of a tumor can vary as a result of routine biological processes like breathing, swallowing, or food digestion.  Consequently, doctors face challenges visualizing tumors and their movements while administering high doses of radiation therapy. This makes precise treatment delivery a much more difficult task.


Over 30 years after the first breakthrough with SBRT, a new version of SBRT was developed. This new, groundbreaking method, called magnetic resonance-guided daily adaptive SBRT (MRg-A-SBRT), constantly adjusts to these movements, enabling medical professionals to tailor their treatment with greater accuracy [4]. Before, SBRT had seen a success rate of about 80%. However this statistic is extremely misleading and is often the result of extremely high doses of radiation therapy being administered [3]. Oftentimes, when radiation therapy is used, even if the cancer itself is removed and the SBRT was “successful”, the side effects from the high doses of chemotherapy results in decreased immune function and patients often succumb to other unrelated diseases due to their weakened immune system. A new 2023 study shows that MRg-A-SBRT has fewer side effects than a standard CT-SBRT [5]. Fewer side effects can result in improved patient health and an increase in life expectancy. You would think that there would be a tradeoff and the reduction in side effects would result in a lower resolution imaging of a cancerous tumor, right? This is surprisingly not the case. MRg-A-SBRT has an increased rate of efficiency when compared to standard SBRT, since it uses MRI, which allows doctors to visualize tumors with better resolution [4]. In essence, this new treatment has fewer side effects on patients and is more efficient than the currently used treatments, indicating a potential new ground breaking development in the field of cancer therapy research.


The landscape of cancer treatment has undergone a profound transformation in recent years, offering renewed hope to millions of individuals who battle this disease. The journey from the early treatments of  chemotherapy to the current era of precision medicine and groundbreaking innovations has been nothing short of miraculous, and MRg-A-SBRT is the most recent advancement that has the potential to alter the cancer research field.












References

  1. Tipton, K., & Sullivan, N. (2011, May). Executive summary - stereotactic body radiation therapy - NCBI bookshelf. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK55717/ 

  2. Stereotactic radiation therapy - treatment types - rtanswers.org - answers to your radiation therapy questions. RTAnswers. (n.d.). https://www.rtanswers.org/How-does-radiation-therapy-work/Stereotactic-Radiation-Therapy 

  3. Stereotactic body radiotherapy - Type - Mayo Clinic. (n.d.). Www.mayoclinic.org. Retrieved September 30, 2023, from http://www.mayoclinic.org/tests-procedures/sbrt/pyc-20446794

  4. Imaged-Guided Adaptive Radiation Treatments May Reduce Short-Term Adverse Effects in Patients With Prostate Cancer Compared to Non-Adaptive Treatments. (2023, July 28). Pharmacy Times. http://www.pharmacytimes.com/view/imaged-guided-adaptive-radiation-treatments-may-reduce-short-term-adverse-effects-in-patients-with-prostate-cancer-compared-to-non-adaptive-treatments

  5. Leeman, J. E., Shin, K.-Y., Chen, Y., Mak, R. H., Nguyen, P. L., D’Amico, A. V., & Martin, N. E. (2023). Acute toxicity comparison of magnetic resonance‐guided adaptive versus fiducial or computed tomography‐guided non‐adaptive prostate stereotactic body radiotherapy: A systematic review and meta‐analysis. Cancer. https://doi.org/10.1002/cncr.34836

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