ArticleRadiation oncology (London, England)2019
Benchmarking techniques for stereotactic body radiotherapy for early-stage glottic laryngeal cancer: LINAC-based non-coplanar VMAT vs. Cyberknife planning.
Article in Radiation oncology (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01984502 (A Phase I CyberKnife Accelerated Hemilarynx Stereotactic Radiotherapy Study for Early-stage Glottic Larynx Cancer), which is not on this map. Cited by 7 papers.
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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.
A Phase I CyberKnife Accelerated Hemilarynx Stereotactic Radiotherapy Study for Early-stage Glottic Larynx Cancer
Who cites it
7 citing papers in PubMed, 17 citations in OpenAlex.
- A glimpse into the CyberKnife robotic radiosurgery system: technical specifications and developments during thirty years.Frontiers in oncology · 2026Review
- Ultra-Hypofractionated Radiotherapy for Early-Stage Glottic Cancer: Real-World Data From a Single Center.Head & neck · 2025Article
- The impact of damaging epilepsy and cardiac genetic variant burden in sudden death in the young.Genome medicine · 2024Article
- The Evolving Role of Stereotactic Body Radiation Therapy for Head and Neck Cancer: Where Do We Stand?Cancers · 2023Review
- Dose-Volume Comparison of IMRT and PSPT Treatment Plans for Early-Stage Glottic Cancer.International journal of particle therapy · 2020Article
- Clinical analysis of EBRT vs TLM in the treatment of early (T1-T2N0) glottic laryngeal cancer.Journal of Cancer · 2020Article
- Radiobiological Comparison of Acuros External Beam and Anisotropic Analytical Algorithm on Esophageal Carcinoma Radiotherapy Treatment Plans.Dose-response : a publication of International Hormesis SocietyArticle
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionStereotactic body radiation therapy (SBRT) was found effective in treating laryngeal cancer with only five treatment fractions by a recent clinical trial (NCT01984502, ClinicalTrials.gov). Nevertheless, this trial used the Cyberknife system, which is not widely accessible enough to benefit all patients affected by laryngeal cancer. Our study investigates the feasibility of larynx SBRT treatment planning on a conventional gantry-based LINAC and compares its plan quality with that from the Cyberknife. MATERIALS &
methodsTen larynx SBRT cases were originally treated by Cyberknife using fixed cones in our institution, with plans created and optimized using the Monte-Carlo algorithm in the MultiPlan treatment planning system. These cases were retrospectively planned in the Eclipse planning system for a LINAC with the same prescription dose. We used volumetric modulated arc therapy (VMAT) for larynx SBRT planning in Eclipse and incorporated non-coplanar arcs to approach the Cyberknife's large solid angle delivery space. We used both anisotropic analytical algorithm (AAA) and Acuros XB (AXB) algorithm for dose calculation and compared their accuracy by measurements on an in-house larynx phantom. We compared the LINAC VMAT plans (VMAT-AAA and VMAT-AXB) with the original Cyberknife plans using dosimetric endpoints such as the conformity index, gradient indices (R50, R20), OAR maximum/mean doses, and the monitor units.
resultsPhantom measurement showed that both the AAA and the AXB algorithms provided adequate dose calculation accuracy (94.7% gamma pass rate on 2%/2 mm criteria for AAA vs. 97.3% for AXB), though AXB provided better accuracy in the air cavity. The LINAC-based VMAT plans achieved similar dosimetric endpoints as the Cyberknife planning, and all plans met the larynx SBRT dosimetric constraints. Cyberknife plans achieved an average conformity index of 1.13, compared to 1.20 of VMAT-AXB and 1.19 of VMAT-AAA. The VMAT plans spared the thyroid gland better with average Dmean of 2.4 Gy (VMAT-AXB) and 2.7 Gy (VMAT-AAA), as compared to 4.3 Gy for Cyberknife plans. The VMAT-AAA plans had a slightly lower contralateral arytenoid Dmax (average: 15.2 Gy) than Cyberknife plans (average: 17.9 Gy) with statistical significance, while the contralateral arytenoid Dmax was similar between VMAT-AXB and Cyberknife plans with no statistically significant difference. Cyberknife plans offered slightly better R50 (average: 5.0) than VMAT-AXB (5.9) and VMAT-AAA (5.7) plans. The VMAT plans substantially reduced the plan MUs to less than 1/3 of the Cyberknife plans, and the differences were statistically significant. The other metrics were similar between VMAT and Cyberknife plans with no statistically significant differences.
conclusionsGantry-based LINACs can achieve similar plan quality to Cyberknife systems. Treatment outcome with both methods remains to be investigated.
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