Trial reportRadiation oncology (London, England)2024
Evaluation of PTV margins with daily iterative online adaptive radiotherapy for postoperative treatment of endometrial and cervical cancer: a prospective single-arm phase 2 study.
Trial report in Radiation oncology (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 20 citations in OpenAlex.
- Development of CBCT-Guided Online Adaptive Radiotherapy.Cancers · 2026Review
- Article
- MRI-enhanced online adaptive radiotherapy by virtual integration of a standalone MRI simulator and CBCT-based treatment delivery.Radiation oncology (London, England) · 2026Article
- Effects of air on the dosimetric robustness of treatment plans for prostate cancer in the presence of intrafractional, anatomical changes during online adaptive radiotherapy.Journal of applied clinical medical physics · 2026Article
- Benefits of daily online plan adaptation with reduced margins in neoadjuvant chemoradiotherapy for esophageal cancer.Physics and imaging in radiation oncology · 2026Article
- Potential of margin reduction for cervical cancer radiotherapy in an online adaptive image-guided workflow.Physics and imaging in radiation oncology · 2026Article
- Commissioning and verification of a 3D Monte Carlo independent calculation software for O-ring linac systems.Journal of applied clinical medical physics · 2026Article
- Impact evaluation of intra-fractional variation on online adaptive radiotherapy for postoperative cervical and endometrial cancer.World journal of clinical oncology · 2025Article
- Moderately hypofractionated online adaptive radiotherapy (SWIFT-1) in cervical cancer patients: study protocol for a multi-centered, open-label, two-arm, phase III, randomized controlled study.Radiation oncology (London, England) · 2025Article
- Fan beam computed tomography-guided online adaptive external radiotherapy for cervical cancer achieves pathological complete response: A case report.Oncology letters · 2025Article
- Modeling dosimetric benefits from daily adaptive RT for gynecological cancer patients with and without knowledge-based dose prediction.Journal of applied clinical medical physics · 2025Article
- A comparative analysis of toxicity and treatment outcomes of adaptive radiotherapy and intensity-modulated radiotherapy in cervical cancer.Scientific reports · 2025Article
- Evaluating the Implementation of fan-beam CT-guided online adaptive re-planning in definitive cervical cancer radiotherapy.Frontiers in oncology · 2025Article
- Daily online adaptation enhances target coverage in prostate cancer radiotherapy: a retrospective analysis.Frontiers in oncology · 2025Article
- Automatic delineation of cervical cancer target volumes in small samples based on multi-decoder and semi-supervised learning and clinical application.Scientific reports · 2024Article
- Article
- Moderated Hypofractionated Online Adaptive Radiotherapy in Locally Advanced Cervical Cancer: A Case Report.Cureus · 2024Article
- Article
- Daily Online Adaptive Radiation Therapy of Postoperative Endometrial and Cervical Cancer With PTV Margin Reduction to 5 mm: Dosimetric Outcomes, Acute Toxicity, and First Clinical Experience.Advances in radiation oncology · 2024Article
- Pelvic target volume inter-fractional motion during radiotherapy for cervical cancer with daily iterative cone beam computed tomography.Radiation oncology (London, England) · 2024Article
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundTo determine the optimal planning target volume (PTV) margins for adequate coverage by daily iterative cone-beam computed tomography (iCBCT)-guided online adaptive radiotherapy (oART) in postoperative treatment of endometrial and cervical cancer and the benefit of reducing PTV margins.
methodsFifteen postoperative endometrial and cervical cancer patients treated with daily iCBCT-guided oART were enrolled in this prospective phase 2 study. Pre- and posttreatment iCBCT images of 125 fractions from 5 patients were obtained as a training cohort, and clinical target volumes (CTV) were contoured separately. Uniform three-dimensional expansions were applied to the PTVpre to assess the minimum margin required to encompass the CTVpost. The dosimetric advantages of the proposed online adaptive margins were compared with conventional margin plans (7-15 mm) using an oART emulator in another cohort of 125 iCBCT scans. A CTV-to-PTV expansion was verified on a validation cohort of 253 fractions from 10 patients, and further margin reduction and acute toxicity were studied.
resultsThe average time from pretreatment iCBCT to posttreatment iCBCT was 22 min. A uniform PTV margin of 5 mm could encompass nodal CTVpost in 100% of the fractions (175/175) and vaginal CTVpost in 98% of the fractions (172/175). The margin of 5 mm was verified in our validation cohort, and the nodal PTV margin could be further reduced to 4 mm if ≥ 95% CTV coverage was predicted to be achieved. The adapted plan with a 5 mm margin significantly improved pelvic organ-at-risk dosimetry compared with the conventional margin plan. Grade 3 toxicities were observed in only one patient with leukopenia, and no patients experienced acute urinary toxicity.
conclusionIn the postoperative treatment of endometrial and cervical cancer, oART could reduce PTV margins to 5 mm, which significantly decrease the dose to critical organs at risk and potentially lead to a lower incidence of acute toxicity.
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