Trial reportInternational journal of radiation oncology, biology, physics2022
Results of a Multi-Institutional Phase 2 Clinical Trial for 4DCT-Ventilation Functional Avoidance Thoracic Radiation Therapy.
Trial report in International journal of radiation oncology, biology, physics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Incorporation of Functional Lung Imaging Into Radiation Therapy Planning in Patients With Lung Cancer: A Systematic Review and Meta-Analysis.International journal of radiation oncology, biology, physics · 2024Pooled it
- Efficacy and Safety in Proton Therapy and Photon Therapy for Patients With Esophageal Cancer: A Meta-Analysis.JAMA network open · 2023Pooled it
- Mature Outcomes and Patterns of Failure in the Phase II FLARE-RT Trial of Biological Image-Guided and Risk-Adaptive Chemoradiation for Unresectable NSCLC.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Trial
- Patient-Reported Outcomes: Comparing Functional Avoidance and Standard Thoracic Radiation Therapy in Lung Cancer.JCO clinical cancer informatics · 2025Trial
- Prospective Trial of Functional Lung Avoidance Radiation Therapy for Lung Cancer: Quality of Life Report.International journal of radiation oncology, biology, physics · 2024Trial
- Evaluation of variables predicting PFT changes for lung cancer patients treated on a prospective 4DCT-ventilation functional avoidance clinical trial.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2023Trial
- Definitive radiotherapy for non-small-cell lung cancer: current practice and future directions.Japanese journal of radiology · 2026Review
- Predicting End-of-Treatment Ventilation Response to Radiation Therapy Using Early Treatment Ventilation for Patients With Lung Cancer Treated With Photons and Protons.International journal of radiation oncology, biology, physics · 2026Article
- Quantitative lung tissue functional analysis for pulmonary adverse event risk assessment prior to thoracic radiotherapy.Physics and imaging in radiation oncology · 2026Article
- A Spatiotemporal Transformer Framework on 4D-CT for Early Prediction of Progressive Pulmonary Fibrosis.Journal of imaging informatics in medicine · 2026Article
- Investigating the impact of key algorithm parameters and patient-specific factors on the accuracy of CT ventilation imaging.Journal of applied clinical medical physics · 2026Article
- Predicting ventilation from single breathing phase non-contrast CT using Swin Transformers.Medical physics · 2026Article
- Functional lung avoidance proton radiation therapy planning using anatomy-wise computed tomography-derived lung ventilation imaging.Radiation oncology (London, England) · 2026Article
- Clinical validation of perfusion imaging with pulmonary function test data using Voronoi-based discretization.Physics in medicine and biology · 2026Article
- Simultaneous synthesis of perfusion and ventilation images from CT using a dual-decoder residual attention network for lung disease diagnosis.Journal of applied clinical medical physics · 2026Article
- Four-dimensional computed tomography ventilation imaging-guided radiotherapy planning in different techniques for lung cancer.Frontiers in oncology · 2026Article
- Detection of phase-binning and interpolation artifacts in 4-dimensional computed tomography imaging using deep learning and rule-based approaches.Medical physics · 2025Article
- Functional lung avoidance stereotactic body radiation therapy for central lung cancer patients.Quantitative imaging in medicine and surgery · 2025Article
- Integrating spot-scanning proton arc therapy with functional avoidance strategies to reduce pulmonary toxicity.Physics and imaging in radiation oncology · 2025Article
- Weekly changes in ventilation response for photon and proton lung cancer patients during radiotherapy.medRxiv : the preprint server for health sciences · 2025Article
Corrections and comments
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Authors and funding
18 authors at 6 institutions in 1 country.
Funding
Abstract
purposeRadiation pneumonitis remains a major limitation in the radiation therapy treatment of patients with lung cancer. Functional avoidance radiation therapy uses functional imaging to reduce pulmonary toxic effects by designing radiation therapy plans that reduce doses to functional regions of the lung. Lung functional imaging has been developed that uses 4-dimensional computed tomography (4DCT) imaging to calculate 4DCT-based lung ventilation (4DCT-ventilation). A phase 2 multicenter study was initiated to evaluate 4DCT-ventilation functional avoidance radiation therapy. The study hypothesis was that functional avoidance radiation therapy could reduce the rate of grade ≥2 radiation pneumonitis to 12% compared with a 25% historical rate, with the trial being positive if ≤16.4% of patients experienced grade ≥2 pneumonitis. METHODS AND MATERIALS: Lung cancer patients receiving curative-intent radiation therapy (prescription doses of 45-75 Gy) and chemotherapy were accrued. Patient 4DCT scans were used to generate 4DCT-ventilation images. The 4DCT-ventilation images were used to generate functional avoidance plans that reduced doses to functional portions of the lung while delivering the prescribed tumor dose. Pneumonitis was evaluated by a clinician at 3, 6, and 12 months after radiation therapy.
resultsSixty-seven evaluable patients were accrued between April 2015 and December 2019. The median prescription dose was 60 Gy (range, 45-66 Gy) delivered in 30 fractions (range, 15-33 fractions). The average reduction in the functional volume of lung receiving ≥20 Gy with functional avoidance was 3.5% (range, 0%-12.8%). The median follow-up was 312 days. The rate of grade ≥2 radiation pneumonitis was 10 of 67 patients (14.9%; 95% upper CI, 24.0%), meeting the phase 2 criteria.
conclusions4DCT-ventilation offers an imaging modality that is convenient and provides functional imaging without an extra procedure necessary. This first report of a multicenter study of 4DCT-ventilation functional avoidance radiation therapy provided data showing that the trial met phase 2 criteria and that evaluation in a phase 3 study is warranted.
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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.