Evidence map›Paper›PMID 37587925›Full record

ArticleClinical and translational radiation oncology2023

A total inverse planning paradigm: Prospective clinical trial evaluating the performance of a novel MR-based 3D-printed head immobilization device.

Paola Anna Jablonska, Amy Parent, Nancy La Macchia, Harley H L Chan, Matthew Filleti, Matthew Ramotar, Young-Bin Cho, Maria Braganza, Adam Badzynski, Normand Laperriere and 8 more

Abstract read
In one paragraph

Article in Clinical and translational radiation oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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.

Paola Anna JablonskaDepartment of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.
Amy ParentRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.
Nancy La MacchiaRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.
Harley H L ChanGuided Therapeutics (GTx) Program, Techna Institute, University Health Network, University of Toronto, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.
Matthew FilletiRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.
Matthew RamotarRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.
Young-Bin ChoDepartment of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.
Maria BraganzaRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.
Adam BadzynskiCancer Digital Intelligence Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.
Normand LaperriereDepartment of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.
Tatiana ConradDepartment of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.
Derek S TsangDepartment of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.
David ShultzDepartment of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.
Anna SantiagoRadiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, 700 University Avenue, 7th Floor, Toronto, Ontario M5G 1Z5, Canada.
Jonathan C IrishGuided Therapeutics (GTx) Program, Techna Institute, University Health Network, University of Toronto, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.
Barbara-Ann MillarDepartment of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.
Tony TadicDepartment of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.
Alejandro BerlinDepartment of Radiation Oncology, University of Toronto, 149 College Street, Unit 504, Toronto, Ontario M5T 1P5, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and purpose: Brain radiotherapy (cnsRT) requires reproducible positioning and immobilization, attained through redundant dedicated imaging studies and a bespoke moulding session to create a thermoplastic mask (T-mask). Innovative approaches may improve the value of care. We prospectively deployed and assessed the performance of a patient-specific 3D-printed mask (3Dp-mask), generated solely from MR imaging, to replicate a reproducible positioning and tolerable immobilization for patients undergoing cnsRT. Material and methods: Patients undergoing LINAC-based cnsRT (primary tumors or resected metastases) were enrolled into two arms: control (T-mask) and investigational (3Dp-mask). For the latter, an in-house designed 3Dp-mask was generated from MR images to recreate the head positioning during MR acquisition and allow coupling with the LINAC tabletop. Differences in inter-fraction motion were compared between both arms. Tolerability was assessed using patient-reported questionnaires at various time points. Results: Between January 2020 - July 2022, forty patients were enrolled (20 per arm). All participants completed the prescribed cnsRT and study evaluations. Average 3Dp-mask design and printing completion time was 36 h:50 min (range 12 h:56 min - 42 h:01 min). Inter-fraction motion analyses showed three-axis displacements comparable to the acceptable tolerance for the current standard-of-care. No differences in patient-reported tolerability were seen at baseline. During the last week of cnsRT, 3Dp-mask resulted in significantly lower facial and cervical discomfort and patients subjectively reported less pressure and confinement sensation when compared to the T-mask. No adverse events were observed. Conclusion: The proposed total inverse planning paradigm using a 3D-printed immobilization device is feasible and renders comparable inter-fraction performance while offering a better patient experience, potentially improving cnsRT workflows and its cost-effectiveness.

Indexed as

3D printingImmobilization deviceMaskMR-guidanceRadiotherapy

Identifiers

PMID37587925
PMCPMC10425893

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.