ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2020
Differences between planned and delivered dose for head and neck cancer, and their consequences for normal tissue complication probability and treatment adaptation.
Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Markov models for clinical decision-making in radiation oncology: A systematic review.Journal of medical imaging and radiation oncology · 2024Pooled it
- Evaluating synthetic CT from deformable registration in directed adaptive radiotherapy for head and neck cancer.Journal of applied clinical medical physics · 2026Article
- Estimation of accumulated dose to organs at risk in head and neck cancer patients treated with scheduled replanning and dose painting in the ARTFORCE trial.Physics and imaging in radiation oncology · 2026Article
- Article
- Cost-effectiveness of personalized policies for implementing organ-at-risk sparing adaptive radiation therapy in head and neck cancer.Physics and imaging in radiation oncology · 2025Article
- Uncertainties in outcome modelling in radiation oncology.Physics and imaging in radiation oncology · 2025Review
- Automated daily dose accumulation workflow for treatment quality assurance during online adaptive radiotherapy with a 0.35T MR-linac.Journal of applied clinical medical physics · 2025Article
- Optimal timing of organs-at-risk-sparing adaptive radiation therapy for head-and-neck cancer under re-planning resource constraints.Physics and imaging in radiation oncology · 2025Article
- Optimal Timing of Organs-at-Risk-Sparing Adaptive Radiation Therapy for Head- and-Neck Cancer under Re-planning Resource Constraints.medRxiv : the preprint server for health sciences · 2024Article
- Investigation of autosegmentation techniques on T2-weighted MRI for off-line dose reconstruction in MR-linac workflow for head and neck cancers.Medical physics · 2024Article
- In Silico Analysis of Adjuvant Head and Neck Online Adaptive Radiation Therapy.Advances in radiation oncology · 2024Article
- Adaptive Proton Therapy for Pediatric Parameningeal Rhabdomyosarcoma: On-Treatment Anatomic Changes and Timing to Replanning.Clinical oncology (Royal College of Radiologists (Great Britain)) · 2023Article
- Article
- DIR-based models to predict weekly anatomical changes in head and neck cancer proton therapy.Physics in medicine and biology · 2022Article
- Dose accumulation for MR-guided adaptive radiotherapy: From practical considerations to state-of-the-art clinical implementation.Frontiers in oncology · 2022Review
- Article
- Initial Feasibility and Clinical Implementation of Daily MR-Guided Adaptive Head and Neck Cancer Radiation Therapy on a 1.5T MR-Linac System: Prospective R-IDEAL 2a/2b Systematic Clinical Evaluation of Technical Innovation.International journal of radiation oncology, biology, physics · 2021Article
- Future-proof Radiation therapist (RTT) practice in a pandemic - Lessons learnt from COVID-19.Technical innovations & patient support in radiation oncology · 2021Article
- Accurate estimation of daily delivered radiotherapy dose with an external treatment planning system.Physics and imaging in radiation oncology · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 3 institutions in 3 countries.
Funding
Abstract
background and purposeAnatomical changes induce differences between planned and delivered dose. Adaptive radiotherapy (ART) may reduce these differences but the optimal implementation is insufficiently clear. The aims of this study were to quantify the difference between planned and delivered dose in HNC patients, assess the consequential difference in normal tissue complication probability (ΔNTCP) and to explore the value of ΔNTCP as an objective selection strategy for ART. MATERIALS AND
methodsFor 52 patients, daily doses were accumulated to estimate the delivered dose. The difference from planned dose was analyzed for CTVs and 9 organs-at-risk (OAR). ΔNTCP was calculated for xerostomia, dysphagia, parotid gland dysfunction and tube feeding dependency at 6 months. ART was deemed necessary if ΔNTCP was >5%. The positive predicted value (PPV) was calculated for identification of ART-patients by clinical judgement, and ΔNTCP at fraction 10 and 15.
resultsΔNTCP >5% was seen five times for dysphagia and twice for the other toxicities. Only 5/9 patients with any ΔNTCP >5% clinically received ART, although ART had been done for 13/52 patients (PPV: 0.38). PPV was 0.86 and 0.75 for accumulated dose at fraction 10 and 15, respectively, using a ΔNTCP cut-off for the allocation of ART of 5%. Using other ΔNTCP cut-offs did not substantially improve PPV. With this cut-off the negative predictive value was 0.93 for ΔNTCP method of fraction 10 and fraction 15, and 0.90 for clinical judgement.
conclusionTo identify patients accurately for ART, NTCP calculations based on the dose differences between planned and delivered dose at fraction 10 are superior to clinical judgement.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.