Summary 209 delivery in case of (unexpected) anatomical changes. These technologies include multileaf collimator (MLC)-tracking and exceptional gating. Only when such technologies have become clinically available, the precision of the treatment can be further improved, and error margins can be reduced. This will potentially result in improved toxicity outcomes and allows further dose escalation. Also, it would provide an opportunity to safely treat patients with recurrent prostate cancer in a non-invasive manner with SBRT in one or two fractions. At this point in time, the MRLinac already brings some advantages to prostate cancer patients, such as the lack of need for fiducials and tattoos for positioning. However, with respect to oncological and toxicity outcomes, the added benefit of MRI-guidance still has to be determined. It is of utmost importance that the potential benefits of MRI-guided treatment are thoroughly investigated, preferably by conducting prospective, randomised clinical trials. Only then, the added value of MR-Linac treatment for prostate cancer, with respect to oncological and toxicity outcomes, can be determined. This applies to both MRI-guided treatment for primary and recurrent localised prostate cancer. 10
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