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The current intensity-modulated or image-guided radiation therapy (IMRT,IGRT) uses fractionation based on planning images.To compensate for the dose delivery error due to the patient deformation in each fraction,adaptive radiation therapy is becoming increasingly important for the overall treatment performance.This talk addresses the challenges toward the clinical practice of adaptive radiation therapy.Specifically,the first part of the presentation focuses on the improvement of CT imaging accuracy on the treatment machines for the calculation of"dose of the day".Main artifacts in the current cone-beam CT images are identified and promising solutions are presented.Inverse treatment re-planning schemes for the known previous dose delivery are then discussed.In the treatment planning optimization,a mathematically "sparse" solution results in a small number of beam segments and therefore is preferred for a high efficiency of dose delivery.To achieve such a treatment plan,a novel framework of treatment planning is proposed using compressed sensing techniques.Implementations of this framework in the current IMRT applications are shown.The talk finally discusses the future work for the eventual clinical implementation of adaptive radiation therapy.