ArticleJournal of applied clinical medical physics2020
FFF-VMAT for SBRT of lung lesions: Improves dose coverage at tumor-lung interface compared to flattened beams.
Article in Journal of applied clinical medical physics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 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
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Stereotactic body radiotherapy for early-stage lung cancer: a systematic review on the choice of photon energy and linac flattened/unflattened beams.Radiation oncology (London, England) · 2024Pooled it
- Novel DCAT plans in stereotactic body radiotherapy for stage I/II centrally located non-small-cell lung cancer.Scientific reports · 2026Article
- Small-volume plan optimization of inoperable early-stage centrally-located non-small-cell lung cancer using VMAT-based SBRT under the DIBH scenario: a single-arc model or a dual-arc plan?Frontiers in oncology · 2026Article
- Optimizing lung SBRT delivery: A hybrid approach combining dynamic conformal arc (DCA) and volumetric modulated arc therapy (VMAT) techniques.Journal of applied clinical medical physics · 2025Article
- Impact of magnetic fields on small field dosimetry for parallel MR-linacs.Medical physics · 2025Article
- Comprehensive plan quality assessment of simplified volumetric-modulated arc therapy for lung stereotactic body radiotherapy.Radiological physics and technology · 2025Article
- Article
- Stereotactic body radiotherapy with volumetric intensity-modulated arc therapy and flattening filter-free beams: dosimetric considerations.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Article
- Novel breath-hold liver target stereotactic ablative radiotherapy using the intrafraction diaphragm registration of kilovoltage projection streaming image with digitally reconstructed radiography of the planning computed tomography.Technical innovations & patient support in radiation oncology · 2023Article
- Feasibility of a simultaneously integrated boost concept for hypofractionated stereotactic radiotherapy of unresected brain metastases.Radiation oncology (London, England) · 2023Article
- Dosimetric comparison in sparing normal tissue dosage by using auto-SBRT planning in oligo liver tumors.Frontiers in oncology · 2023Article
- Comparison of the dose distribution of the VMAT radiotherapy technique depending on the beam used: FFF-X10MV and FFF-X15MV.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2023Article
- Evaluation of flattening-filter-free and flattening filter dosimetric and radiobiological criteria for lung SBRT: A volume-based analysis.Frontiers in oncology · 2023Article
- Planning issues on linac-based stereotactic radiotherapy.World journal of clinical cases · 2022Review
- Volumetric modulated arc therapy (VMAT): a review of clinical outcomes-what is the clinical evidence for the most effective implementation?The British journal of radiology · 2022Review
- Feasibility of using ring-mounted Halcyon Linac for single-isocenter/two-lesion lung stereotactic body radiation therapy.Journal of applied clinical medical physics · 2022Article
- Monte Carlo evaluation of target dose coverage in lung stereotactic body radiation therapy with flattening filter-free beams.Journal of radiotherapy in practice · 2022Article
- A single centre evaluation of the 2019 UK SABR consortium guidelines for primary lung cancer: correlation between Prescription Dose Spillage and inverse Paddick Conformity Index.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2022Article
- Simulation of dosimetric consequences of intrafraction variation of tumor drift in lung cancer stereotactic body radiotherapy.Frontiers in oncology · 2022Article
- Using FFF Beams to Improve the Therapeutic Ratio of Lung SBRT.Journal of radiotherapy in practice · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo quantify the differences in dosimetry as a function of ipsilateral lung density and treatment delivery parameters for stereotactic, single dose of volumetric modulated arc therapy (VMAT) lung stereotactic body radiation therapy (SBRT) delivered with 6X flattening filter free (6X-FFF) beams compared to traditional flattened 6X (6X-FF) beams. MATERIALS/
methodsThirteen consecutive early stage I-II non-small-cell-lung cancer (NSCLC) patients were treated with highly conformal noncoplanar VMAT SBRT plans (3-6 partial arcs) using 6X-FFF beam and advanced Acuros-based dose calculations to a prescription dose of 30 Gy in one fraction to the tumor margin. These clinical cases included relatively smaller tumor (island tumors) sizes (2.0-4.2 cm diameters) and varying average ipsilateral lung densities between 0.14 g/cc and 0.34 g/cc. Treatment plans were reoptimized with 6X-FF beams for identical beam/arc geometries and planning objectives. For same target coverage, the organs-at-risk (OAR) dose metrics as a function of ipsilateral lung density were compared between 6X-FFF and 6X-FF plans. Moreover, monitor units (MU), beam modulation factor (MF) and beam-on time (BOT) were evaluated.
resultsBoth plans met the RTOG-0915 protocol compliance. The ipsilateral lung density and the tumor location heavily influenced the treatment plans with 6X-FFF and 6X-FF beams, showing differences up to 12% for the gradient indices. For similar target coverage, 6X-FFF beams showed better target conformity, lower intermediate dose-spillage, and lower dose to the OAR. Additionally, BOT was reduced by a factor of 2.3 with 6X-FFF beams compared to 6X-FF beams.
conclusionWhile prescribing dose to the tumor periphery, 6X-FFF VMAT plans for stereotactic single-dose lung SBRT provided similar target coverage with better dose conformity, superior intermediate dose-spillage (improved dose coverage at tumor interface), and improved OAR sparing compared to traditional 6X-FF beams and significantly reduced treatment time. The ipsilateral lung density and tumor location considerably affected dose distributions requiring special attention for clinical SBRT plan optimization on a per-patient basis. Clinical follow up of these patients for tumor local-control rate and treatment-related toxicities is in progress.
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.