Evidence map›Paper›PMID 33449952›Full record

ArticlePloS one2021

Evaluation of a generalized knowledge-based planning performance for VMAT irradiation of breast and locoregional lymph nodes-Internal mammary and/or supraclavicular regions.

Maria Rago, Lorenzo Placidi, Mattia Polsoni, Giulia Rambaldi, Davide Cusumano, Francesca Greco, Luca Indovina, Sebastiano Menna, Elisa Placidi, Gerardina Stimato and 8 more

Abstract read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

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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

18 authors.

Maria RagoUniversità Cattolica del Sacro Cuore, Rome, Italy.
Lorenzo PlacidiUniversità Cattolica del Sacro Cuore, Rome, Italy.ORCID 0000-0003-0058-9145
Mattia PolsoniFatebenefratelli Isola Tiberina, Ospedale San Giovanni Calibita, Rome, Italy.
Giulia RambaldiFatebenefratelli Isola Tiberina, Ospedale San Giovanni Calibita, Rome, Italy.
Davide CusumanoFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Francesca GrecoFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Luca IndovinaFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Sebastiano MennaFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Elisa PlacidiFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Gerardina StimatoFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Stefania TeodoliFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Gian Carlo MattiucciFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Silvia ChiesaFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Fabio MarazziFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Valeria MasielloFondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Vincenzo ValentiniUniversità Cattolica del Sacro Cuore, Rome, Italy.
Marco De SpiritoUniversità Cattolica del Sacro Cuore, Rome, Italy.
Luigi AzarioUniversità Cattolica del Sacro Cuore, Rome, Italy.ORCID 0000-0001-8575-8627

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo evaluate the performance of eleven Knowledge-Based (KB) models for planning optimization (RapidPlantm (RP), Varian) of Volumetric Modulated Arc Therapy (VMAT) applied to whole breast comprehensive of nodal stations, internal mammary and/or supraclavicular regions. METHODS AND MATERIALS: Six RP models have been generated and trained based on 120 VMAT plans data set with different criteria. Two extra-structures were delineated: a PTV for the optimization and a ring structure. Five more models, twins of the previous models, have been created without the need of these structures.

resultsAll models were successfully validated on an independent cohort of 40 patients, 30 from the same institute that provided the training patients and 10 from an additional institute, with the resulting plans being of equal or better quality compared with the clinical plans. The internal validation shows that the models reduce the heart maximum dose of about 2 Gy, the mean dose of about 1 Gy and the V20Gy of 1.5 Gy on average. Model R and L together with model B without optimization structures ensured the best outcomes in the 20% of the values compared to other models. The external validation observed an average improvement of at least 16% for the V5Gy of lungs in RP plans. The mean heart dose and for the V20Gy for lung IPSI were almost halved. The models reduce the maximum dose for the spinal canal of more than 2 Gy on average.

conclusionsAll KB models allow a homogeneous plan quality and some dosimetric gains, as we saw in both internal and external validation. Sub-KB models, developed by splitting right and left breast cases or including only whole breast with locoregional lymph nodes, have shown good performances, comparable but slightly worse than the general model. Finally, models generated without the optimization structures, performed better than the original ones.

Indexed as

Radiotherapy, Intensity-ModulatedBreast NeoplasmsFemaleHumansLymph NodesMammary Glands, HumanMediastinumOrgans at RiskRadiation, IonizingRadiotherapy, AdjuvantRadiotherapy DosageRadiotherapy Planning, Computer-AssistedRetrospective Studies

Identifiers

PMID33449952
PMCPMC7810311

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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.