Meta-analysis of acute toxicity with magnetic resonance-guided adaptive versus CT-guided non-adaptive prostate SBRT

Stereotactic body radiotherapy (SBRT) is gaining wider adoption for prostate cancer management but there remain significant toxicity risks when delivering prostate SBRT with standard techniques. Magnetic resonance-guided daily adaptive SBRT (MRg-A-SBRT) offers technological advantages in precision of radiation dose delivery, but the toxicity profile associated with MRg-A-SBRT compared with standard fiducial or computed tomography-guided non-adaptive prostate SBRT (CT-SBRT) remains unknown. A meta-analysis of 29 studies including 2547 patients found that MRg-A-SBRT was associated with a reduction in risk of acute urinary and gastrointestinal toxicity when compared with CT-SBRT.