Evidence map›Paper›PMID 36237114›Full record

ArticleJournal of applied clinical medical physics2022

Feasibility of radical cardiac-sparing, treatment planning strategies for patients with locally advanced, non-small cell lung cancer.

Joshua P Kim, Jake Dewalt, Aharon Feldman, Khaled Adil, Benjamin Movsas, Indrin J Chetty

Registry-linked trialOpen 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. It is linked to trial NCT04731571 (Toward High Fidelity Adaptive Radiotherapy in the Thorax), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 24% 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.

NCT04731571 completednot on this map

Toward High Fidelity Adaptive Radiotherapy in the Thorax

TypeobservationalSponsorHenry Ford Health SystemRan2021 to 2025Enrolled20ConditionsCarcinoma, Non-Small-Cell Lung
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 4 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

6 authors at 1 institution in 1 country.

Joshua P KimDepartment of Radiation Oncology, Henry Ford Health System, Detroit, Michigan, USA.
Jake DewaltDepartment of Radiation Oncology, Henry Ford Health System, Detroit, Michigan, USA.
Aharon FeldmanDepartment of Radiation Oncology, Henry Ford Health System, Detroit, Michigan, USA.
Khaled AdilDepartment of Radiation Oncology, Henry Ford Health System, Detroit, Michigan, USA.
Benjamin MovsasDepartment of Radiation Oncology, Henry Ford Health System, Detroit, Michigan, USA.
Indrin J ChettyDepartment of Radiation Oncology, Henry Ford Health System, Detroit, Michigan, USA.
Henry Ford Health System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA set of treatment planning strategies were designed and retrospectively implemented for locally advanced, non-small cell lung cancer (NSCLC) patients in order to minimize cardiac dose without compromising target coverage goals.

methodsRetrospective analysis was performed for 20 NSCLC patients prescribed to 60-66 Gy that received a mean heart dose (MHD) ≥10 Gy. Three planning approaches were designed and implemented. The first was a multi-isocentric (MI) volume-modulated arc therapy (VMAT) approach (HEART_MI) with one isocenter located within the tumor and the second chosen up to 10 cm away longitudinally. The second was a noncoplanar (NCP) VMAT approach (HEART_NCP) utilizing up to three large couch angles and a standard arc at couch 0. The final planning strategy took a mixed approach (HEART_HYBRID) utilizing the HEART_NCP strategy for two thirds of the treatment combined with a plan utilizing a pair of opposite-opposed gantry angles for the remaining treatments. Investigational plans were compared to original plans using dose-volume histogram metrics such as organ volume receiving greater than x Gy (Vx) or mean dose (Dmean).

resultsAlthough there was a small but statistically significant decrease in internal target volume coverage for HEART_MI plans and, conversely, a statistically significant increase for HEART_NCP plans, all generated plans met physician-prescribed target constraints. For heart dose, there were statistically significant decreases in all heart metrics and particularly MHD for the HEART_MI (9.8 vs. 15.4 Gy [p < 0.001], respectively), HEART_NCP (9.2 vs. 15.4 Gy [p < 0.001]), respectively), and HEART_HYBRID (7.9 vs. 15.4 Gy [p < 0.001], respectively) strategies.

conclusionsThe strategy providing the best compromise between plan quality and cardiac dose reduction was HEART_NCP, which produced MHD reductions of 37.6% ± 12.9% (6.2 ± 3.4 Gy) relative to original plans. This strategy could potentially reduce adverse cardiac events, leading to improved quality of life for these patients.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsRadiotherapy, Intensity-ModulatedFeasibility StudiesHumansOrgans at RiskQuality of LifeRadiotherapy DosageRadiotherapy Planning, Computer-AssistedRetrospective StudiescardiacNSCLCtreatment planning

Identifiers

PMID36237114
PMCPMC9797161
OpenAlexW4306157722

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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.