外部束放射治疗（EBRT）是治疗局限性前列腺癌的重要支柱。目前的图像引导放射治疗（IGRT）技术允许在每个疗程前使用成像更加准确和精确地进行辐射治疗。磁共振引导放射治疗（MRgRT）是IGRT的下一步发展，采用线性加速器与MRI扫描仪相结合的混合系统。采用MRgRT，可以详细可视化盆腔解剖结构，并随后在每个放射治疗疗程前执行放射剂量重新计划。该技术有可能通过减少边缘并更加准确地送达靶区剂量，增加EBRT治疗窗口，并改善正常组织保护。对于前列腺癌，其生物学更适合于超低剂量分数辐射，可将放疗治疗量减少至仅五个疗程。此外，最近的研究表明，将局限于前列腺内的肿瘤诱导剂量升高可显著增加无病生存期。在本文中，我们讨论了这些独特机会以及MRgRT在前列腺癌治疗中的潜在未来优势。© 2022. 作者（们），在Springer Nature Limited的独家许可下。

External beam radiotherapy (EBRT) is an important cornerstone in the treatment of localized prostate cancer. Current image-guided radiotherapy (IGRT) techniques allow for more accurate and precise delivery of radiation treatment by the use of imaging before each fraction. Magnetic resonance guided radiotherapy (MRgRT) is the next step in IGRT with hybrid systems combining linear accelerators with MRI-scanners. With MRgRT, it is possible to visualize pelvic anatomy in great detail and subsequently perform replanning of the radiation dose distribution before each radiotherapy fraction. This technique has the potential to increase the therapeutic window of EBRT, by improved normal tissue sparing due to margin reduction and more accurate target dose delivery. This is particularly promising for prostate cancer, with its biology lending itself to ultra-hypofractionation, reducing radiotherapy treatment to as little as five fractions. Also, recent studies have shown that focal dose escalation to the intraprostatic tumor to high ablative doses can substantially increase disease-free survival. In this article, we discuss these unique opportunities as well as the potential future benefits of MRgRT in prostate cancer treatment.© 2022. The Author(s), under exclusive licence to Springer Nature Limited.