UCLA Journal of Radiation Oncology SPRING 2024 - Flipbook - Page 30
UCLA RADIATION ONCOLOGY JOURNAL
NAVIGATING NEW WAYS TO TREAT CANCER:
HOW MRI-GUIDED RADIATION THERAPY
(MRGRT) IS CHANGING HEALTHCARE
In this review article, UCLA physicians from the Department of Radiation Oncology provide a
comprehensive overview of the potential benefits, challenges, and economic considerations
associated with MRgRT. Unlike traditional methods, MRgRT uses real-time imaging from magnetic
resonance imaging (MRI) to guide and adapt radiation therapy, allowing for more precise and
effective treatments. While the technology has the potential to revolutionize the field and may
even change the standard process of treatment planning and delivery, the authors note that
careful evaluation from a healthcare economic and policy perspective is required for its successful
implementation, as incorporation of any type of new technology requires that it demonstrates value
within the healthcare system. Current evidence suggests that while MRgRT may involve higher initial
costs, its advantages in terms of improved outcomes and streamlined processes could ultimately
make it cost-effective. Clinical trials, such as the MIRAGE trial, indicate potential benefits of MRgRT,
including a reduction in acute genitourinary and gastrointestinal toxicities compared to CT-guided
radiation therapy. While the MIRAGE trial demonstrated the toxicity benefits that MRgRT can
provide, the SMART trial further demonstrated the potential advantages of MRgRT by incorporating
adaptive planning with MRgRT for pancreatic cancer. This review highlighted the capability for
on-table adaptive radiation therapy in real-time, which allows for target dose escalation while
reducing the risk of injury to surrounding tissues. While the advantage of MRgRT with respect to
cancer outcomes make it appealing from the value perspective, the authors emphasize the need for
additional evidence, including cost-effectiveness analyses and patient-reported outcomes, to support
the widespread adoption of MRgRT. The review's first author is Dr. Travis Courtney, a Radiation
Oncology Resident at UCLA. The senior author is Dr. Michael Steinberg, Professor and Chair of
Radiation Oncology at the David Geffen School of Medicine. ☐
Contributed by: Denise Heady
Denise Heady is a science communications and media relations manager at UCLA Health. She covers the clinical cancer program along
with basic and clinical translational research for the UCLA Health Jonsson Comprehensive Cancer Center.
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