Adaptive Radiotherapy

Conventional radiotherapy is a standardized workflow where a patient undergoes a simulation and a treatment plan is generated from these images. This plan is delivered throughout the entire treatment, which typically spans 1–6 weeks, without modification. However, anatomical or tumor changes during treatment can make the initial plan suboptimal. Adaptive radiotherapy (ART) addresses these changes by tailoring the treatment plan to the patient’s evolving needs, either offline or online, to improve tumor coverage and minimize toxicity to organs at risk (OAR). Due to its complexity, ART requires the need for modifications from traditional workflows. Aspects such as plan robustness, potential anatomical changes, and the role of automation must be considered.