MR-LINAC, a New Partner in Radiation Oncology: Current Landscape

Simple Summary This manuscript is entitled "MR-LINAC, a new partner in radiation oncology: current landscape" in response to your invitation to collaborate on the Special Issue on "Hypofractionated Radiotherapy in Cancer Treatments". The main contribution of this review is to provide an update on the scientific evidence regarding the role of new technology in radiation oncology: the MR-LINAC. These data are relevant because there have been important advances in the management of different pathologies with this LINAC, principally high dose and SBRT, with promising results in recent years.Abstract Technological advances in radiation oncology are oriented towards improving treatment precision and tumor control. Among these advances, magnetic-resonance-image-guided radiation therapy (MRgRT) stands out, with technological advances to deliver targeted treatments adapted to a tumor's anatomy on the day while minimizing incidental exposure to organs at risk, offering an unprecedented therapeutic advantage compared to X-ray-based IGRT delivery systems. This new technology changes the traditional workflow in radiation oncology and requires an evolution in team coordination to administer more precise treatments. Once implemented, it paves the way for newer indication for radiation therapy to safely deliver higher doses than ever before, with better preservation of healthy tissues to optimize patient outcomes. In this narrative review, we assess the technical aspects of the novel linear accelerators that can deliver MRgRT and summarize the available published experience to date, focusing on oncological results and future challenges.