Evidence map›Paper›PMID 35213089›Full record

ArticleJournal of applied clinical medical physics2022

Maintaining dosimetric quality when switching to a Monte Carlo dose engine for head and neck volumetric-modulated arc therapy planning.

Vladimir Feygelman, Kujtim Latifi, Mark Bowers, Kevin Greco, Eduardo G Moros, Max Isacson, Agnes Angerud, Jimmy Caudell

Open access · goldAbstract read
In one paragraph

Article in Journal of applied clinical medical physics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
3.2field-weighted citation impact, top 9% 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

8 citing papers in PubMed, 12 citations in OpenAlex.

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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

8 authors at 2 institutions in 2 countries.

Vladimir FeygelmanDepartment of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA.
Kujtim LatifiDepartment of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA.
Mark BowersDepartment of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA.
Kevin GrecoDepartment of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA.
Eduardo G MorosDepartment of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA.
Max IsacsonRaySearch Laboratories AB, Stockholm, Sweden.
Agnes AngerudRaySearch Laboratories AB, Stockholm, Sweden.
Jimmy CaudellDepartment of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida, USA.
Moffitt Cancer Center · USRaySearch Laboratories (Sweden) · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Head and neck cancers present challenges in radiation treatment planning due to the large number of critical structures near the target(s) and highly heterogeneous tissue composition. While Monte Carlo (MC) dose calculations currently offer the most accurate approximation of dose deposition in tissue, the switch to MC presents challenges in preserving the parameters of care. The differences in dose-to-tissue were widely discussed in the literature, but mostly in the context of recalculating the existing plans rather than reoptimizing with the MC dose engine. Also, the target dose homogeneity received less attention. We adhere to strict dose homogeneity objectives in clinical practice. In this study, we started with 21 clinical volumetric-modulated arc therapy (VMAT) plans previously developed in Pinnacle treatment planning system. Those plans were recalculated "as is" with RayStation (RS) MC algorithm and then reoptimized in RS with both collapsed cone (CC) and MC algorithms. MC statistical uncertainty (0.3%) was selected carefully to balance the dose computation time (1-2 min) with the planning target volume (PTV) dose-volume histogram (DVH) shape approaching that of a "noise-free" calculation. When the hot spot in head and neck MC-based treatment planning is defined as dose to 0.03 cc, it is exceedingly difficult to limit it to 105% of the prescription dose, as we were used to with the CC algorithm. The average hot spot after optimization and calculation with RS MC was statistically significantly higher compared to Pinnacle and RS CC algorithms by 1.2 and 1.0 %, respectively. The 95% confidence interval (CI) observed in this study suggests that in most cases a hot spot of ≤107% is achievable. Compared to the 95% CI for the previous clinical plans recalculated with RS MC "as is" (upper limit 108%), in real terms this result is at least as good or better than the historic plans.

Indexed as

Radiotherapy, Intensity-ModulatedAlgorithmsHumansMonte Carlo MethodRadiometryRadiotherapy DosageRadiotherapy Planning, Computer-Assistedhead and neck planningMonte Carlo treatment planningtreatment planning algorithm transition

Identifiers

PMID35213089
PMCPMC9121035
OpenAlexW4214604270

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Registered trials

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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.