Adapting to More Than Shape: Leveraging the Full Potential of Adaptive Radiotherapy Technologies
Description
Medical physicists are leading the clinical integration of adaptive radiotherapy (ART), using advanced imaging, automation, and dose recalculation tools to personalize treatments in near real-time. While current implementations primarily adapt to anatomical changes, the expanding landscape of oncology presents an opportunity—and an imperative—to adapt to far more than geometry. Emerging technologies now enable ART to incorporate biological, functional, and temporal information that reflects the evolving tumor and patient state. Recent advances include: (i) use of online and serial imaging biomarkers to guide biologically driven dose escalation and de-escalation; (ii) integration of adaptive planning with immunotherapy, radiopharmaceutical therapy, or nanoparticle theranostics to adjust treatment in response to systemic or microenvironmental effects; and (iii) incorporation of liquid biopsies and circulating biomarkers to monitor tumor evolution. This session will highlight how ART could evolve from a geometry-focused workflow to a comprehensive, biology-informed framework—positioning medical physicists to redefine personalization in radiotherapy and support a new era of adaptive oncology.