Trial reportInternational journal of radiation oncology, biology, physics2018
Interim Analysis of a Two-Institution, Prospective Clinical Trial of 4DCT-Ventilation-based Functional Avoidance Radiation Therapy.
Trial report in International journal of radiation oncology, biology, physics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 40 citations in OpenAlex.
- Evaluation of variables predicting PFT changes for lung cancer patients treated on a prospective 4DCT-ventilation functional avoidance clinical trial.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2023Trial
- Results of a Multi-Institutional Phase 2 Clinical Trial for 4DCT-Ventilation Functional Avoidance Thoracic Radiation Therapy.International journal of radiation oncology, biology, physics · 2022Trial
- Functional lung avoidance proton radiation therapy planning using anatomy-wise computed tomography-derived lung ventilation imaging.Radiation oncology (London, England) · 2026Article
- Integrating spot-scanning proton arc therapy with functional avoidance strategies to reduce pulmonary toxicity.Physics and imaging in radiation oncology · 2025Article
- Comprehensive clinical evaluation of novel 4DCT-based lung function imaging methods.Journal of applied clinical medical physics · 2025Article
- Article
- Microbiota-mediated modulation of radiosensitivity: mechanisms and therapeutic prospects of oral and gut microbiota, metabolites, and probiotics.Frontiers in microbiology · 2025Review
- Systematic Evaluation of the Impact of Lung Segmentation Methods on 4-Dimensional Computed Tomography Ventilation Imaging Using a Large Patient Database.International journal of radiation oncology, biology, physics · 2024Article
- An analysis of the regional heterogeneity in tissue elasticity in lung cancer patients with COPD.Frontiers in medicine · 2023Article
- Normal Lung Tissue CT Density Changes after Volumetric-Arc Radiotherapy (VMAT) for Lung Cancer.Journal of personalized medicine · 2022Article
- Different functional lung-sparing strategies and radiotherapy techniques for patients with esophageal cancer.Frontiers in oncology · 2022Article
- Deriving Pulmonary Ventilation Images From Clinical 4D-CBCT Using a Deep Learning-Based Model.Frontiers in oncology · 2022Article
- HyperpolarizedInternational journal of radiation oncology, biology, physics · 2021Article
- Feasibility of function-guided lung treatment planning with parametric response mapping.Journal of applied clinical medical physics · 2021Article
- Functional avoidance-based intensity modulated proton therapy with 4DCT derived ventilation imaging for lung cancer.Journal of applied clinical medical physics · 2021Article
- Characterizing spatial differences between SPECT-ventilation and SPECT-perfusion in patients with lung cancer undergoing radiotherapy.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2021Article
- Quantifying pulmonary perfusion from noncontrast computed tomography.Medical physics · 2021Article
- An assessment of the correlation between robust CT-derived ventilation and pulmonary function test in a cohort with no respiratory symptoms.The British journal of radiology · 2021Article
- Evaluating Positron Emission Tomography-Based Functional Imaging Changes in the Heart After Chemo-Radiation for Patients With Lung Cancer.International journal of radiation oncology, biology, physics · 2020Article
- Accounting for respiratory motion in small serial structures during radiotherapy planning: proof of concept in virtual bronchoscopy-guided lung functional avoidance radiotherapy.Physics in medicine and biology · 2019Article
Corrections and comments
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Authors and funding
17 authors at 5 institutions in 1 country.
Funding
Abstract
purposeFunctional imaging has been proposed that uses 4DCT images to calculate 4DCT-based lung ventilation (4DCT-ventilation). We have started a 2-institution, phase 2 prospective trial evaluating the feasibility, safety, and preliminary efficacy of 4DCT-ventilation functional avoidance. The trial hypothesis is that the rate of grade ≥2 radiation pneumonitis could be reduced to 12% with functional avoidance, compared with a 25% rate of pneumonitis with a historical control. The trial employed a Simon 2-stage design with a planned futility analysis after 17 evaluable patients. The purpose of this work is to present the trial design and implementation, dosimetric data, and clinical results for the planned futility analysis. METHODS AND MATERIALS: Eligible patients were patients with lung cancer who were prescribed doses of 45 to 75 Gy. For each patient, the 4DCT data were used to generate a 4DCT-ventilation image using the Hounsfield unit technique along with a compressible flow-based image registration algorithm. Two intensity modulated radiation therapy treatment plans were generated: (1) a standard lung plan and (2) a functional avoidance treatment plan that aimed to reduce dose to functional lung while meeting target and normal tissue constraints. Patients were treated with the functional avoidance plan and evaluated for thoracic toxicity (presented as rate and 95% confidence intervals [CI]) with a 1-year follow-up.
resultsThe V20 to functional lung was 21.6% ± 9.5% (mean ± standard deviation) with functional avoidance, representing a decrease of 3.2% (P < .01) relative to standard, nonfunctional treatment plans. The rates of grade ≥2 and grade ≥3 radiation pneumonitis were 17.6% (95% CI, 3.8%-43.4%) and 5.9% (95% CI, 0.1%-28.7%), respectively.
conclusionsDosimetrically, functional avoidance achieved reduction in doses to functional lung while meeting target and organ at risk constraints. On the basis of Simon's 2-stage design and the 17.6% grade ≥2 pneumonitis rate, the trial met its futility criteria and has continued accrual.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.