Evidence map›Paper›PMID 33052286›Full record

ArticleCureus2020

Initial Clinical Experience Treating Patients With Lung Cancer on a 6MV-Flattening-Filter-Free O-Ring Linear Accelerator.

Andrew R Barsky, Hui Lin, Amberly Mendes, Alexandra Dreyfuss, Christopher Wright, Emily J Anstadt, Abigail T Berman, William P Levin, Keith A Cengel, Nathan Anderson and 4 more

Open access · diamondAbstract read
In one paragraph

Article in Cureus, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 34% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 2 institutions in 1 country.

Andrew R BarskyDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
Hui LinDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
Amberly MendesDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
Alexandra DreyfussDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, USA.
Christopher WrightDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
Emily J AnstadtDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
Abigail T BermanDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
William P LevinDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
Keith A CengelDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
Nathan AndersonDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
Lei DongDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
James M MetzDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
Taoran LiDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
Steven FeigenbergDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, USA.
Hospital of the University of Pennsylvania · USMemorial Sloan Kettering Cancer Center · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

Introduction Modern technologies, like intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT), have improved the therapeutic ratio of thoracic radiotherapy (TRT) for lung cancer (LC). Halcyon™ (Varian Medical Systems, Palo Alto, CA, USA), a novel 6MV-flattening-filter-free O-ring linear accelerator (6X-FFF ORL), was designed to deliver IMRT and VMAT with greater speed than a C-arm linac. Herein, we report our initial clinical experience treating patients with LC on this linac. Methods All patients who received TRT for LC on the 6X-FFF ORL at our institution were retrospectively identified. Patients' clinicopathologic data, radiotherapy details, early disease-control and toxicity outcomes, dosimetric data, couch corrections, and treatment times are reported. Results Between 10/2018-12/2019, 30 consecutive patients (median age 66 years, range 54-94 years) received definitive or post-operative TRT for LC (median 66 Gy/33 fractions; range 5-70 Gy/2-37 fractions) following four-dimensional computed tomography (CT) simulation (97%) using daily kilovoltage KV cone-beam CT (CBCT) (100%) on a 6X-FFF ORL for non-small cell LC (84%) or small cell LC (16%), with 53% receiving VMAT, 43% receiving static-field IMRT, and 77% receiving concurrent systemic therapy. All plans were approved through institutional peer review. The average three-dimensional vector couch correction based on CBCT guidance was 0.90 ± 0.50 cm. The average beam-on and beam on plus CBCT times were 1.7 ± 1.1 min, and 5.0 ± 3.2 min, respectively. Grade 3 dyspnea and fatigue occurred in 3% and 3% of patients, respectively. There were no grade ≥4 toxicities. Conclusion In this first clinical report of TRT for LC on a 6X-FFF ORL, daily CBCT-guided treatment was fast and safe with respect to dosimetry and clinical outcomes. Thus, use of this linac for TRT may increase LC patient throughput without a detriment in radiotherapy quality.

Indexed as

flattening filter freeimrtlung cancernon-small cell lung cancerradiationradiotherapysmall cell lung cancerthroughputvmat

Identifiers

PMID33052286
PMCPMC7546605
OpenAlexW3084191996

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.