Delivering adaptive radiotherapy to the bladder during radical treatment

Radical radiotherapy to the bladder for muscle-invasive bladder cancer is a challenging treatment to plan and deliver because of organ mobility and its varying volume. The dynamic target volume can be tracked with imaging during the treatment course, enabling an adaptive response and adjustment of the patient’s individual treatment plan. This article summarises the difficulties encountered when treating the bladder, different approaches to patient imaging and adaptive radiotherapy techniques. Ultimately these technological advances support the delivery of a personalised treatment plan to ensure optimal dose delivery to the tumour and simultaneous sparing of adjacent normal tissue.