ArticleJournal of clinical medicine2022
A Simulation Study of Tolerance of Breathing Amplitude Variations in Radiotherapy of Lung Cancer Using 4DCT and Time-Resolved 4DMRI.
Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
As patient breathing irregularities can introduce a large uncertainty in targeting the internal tumor volume (ITV) of lung cancer patients, and thereby affect treatment quality, this study evaluates dose tolerance of tumor motion amplitude variations in ITV-based volumetric modulated arc therapy (VMAT). A motion-incorporated planning technique was employed to simulate treatment delivery of 10 lung cancer patients' clinical VMAT plans using original and three scaling-up (by 0.5, 1.0, and 2.0 cm) motion waveforms from single-breath four-dimensional computed tomography (4DCT) and multi-breath time-resolved 4D magnetic resonance imaging (TR-4DMRI). The planning tumor volume (PTV = ITV + 5 mm margin) dose coverage (PTV D95%) was evaluated. The repeated waveforms were used to move the isocenter in sync with the clinical leaf motion and gantry rotation. The continuous VMAT arcs were broken down into many static beam fields at the control points (2°-interval) and the composite plan represented the motion-incorporated VMAT plan. Eight motion-incorporated plans per patient were simulated and the plan with the native 4DCT waveform was used as a control. The first (D95% ≤ 95%) and second (D95% ≤ 90%) plan breaching points due to motion amplitude increase were identified and analyzed. The PTV D95% in the motion-incorporated plans was 99.4 ± 1.0% using 4DCT, closely agreeing with the corresponding ITV-based VMAT plan (PTV D95% = 100%). Tumor motion irregularities were observed in TR-4DMRI and triggered D95% ≤ 95% in one case. For small tumors, 4 mm extra motion triggered D95% ≤ 95%, and 6-8 mm triggered D95% ≤ 90%. For large tumors, 14 mm and 21 mm extra motions triggered the first and second breaching points, respectively. This study has demonstrated that PTV D95% breaching points may occur for small tumors during treatment delivery. Clinically, it is important to monitor and avoid systematic motion increase, including baseline drift, and large random motion spikes through threshold-based beam gating.
Indexed as
Identifiers
What OpenQuestion holds
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.