ArticleCureus2024
Enhancing Precision in Radiation Therapy for Locally Advanced Lung Cancer: A Case Study of Cone-Beam Computed Tomography (CBCT)-Based Online Adaptive Techniques and the Promise of HyperSight™ Iterative CBCT.
Article in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Prospective evaluation and clinical outcomes of adaptive radiotherapy for locally advanced non-small cell lung cancer (LA-NSCLC).Acta oncologica (Stockholm, Sweden) · 2026Article
- Simulated online adaptive radiotherapy on C-arm linacs: Integrating high resolution cone-beam CT into abdominal stereotactic body radiation therapy.Journal of applied clinical medical physics · 2026Article
- First evaluation of in-patient dose calculation accuracy on a C-arm Linear Accelerator with advanced Cone-Beam computed tomography (CBCT) imaging.Physics and imaging in radiation oncology · 2026Article
- Leveraging CT-based online adaptive radiotherapy for dose escalation in hypofractionated radiotherapy for locally advanced unresectable lung cancer.Frontiers in oncology · 2026Article
- Correlation between exposure (mAs) and image quality for a rapid cone-beam CT on a ring gantry linear accelerator.Journal of applied clinical medical physics · 2025Article
- Leveraging High-Fidelity Mode for Improved Online Adaptive Stereotactic Accelerated Partial Breast Treatment Efficiency.Advances in radiation oncology · 2025Article
- Localization accuracy of 6-second CBCT for lung IGRT with various breathing patterns.Journal of applied clinical medical physics · 2025Article
- Improving efficiency in lung SAbR planning using integrated tools for X-ray based adaptive radiotherapy.Journal of applied clinical medical physics · 2025Article
- Are treatment plans optimized on the basis of acuros XB dose calculation robust against anatomic changes during online adaptive radiotherapy for lung cancer regarding dose homogeneity?Radiation oncology (London, England) · 2025Article
- Assessing Dosimetric Benefits of Cone Beam Computed Tomography-Guided Online Adaptive Radiation Treatment Frequencies for Lung Cancer.Advances in radiation oncology · 2025Article
- Clinical feasibility of Ethos auto-segmentation for adaptive whole-breast cancer treatment.Frontiers in oncology · 2024Article
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Authors and funding
4 authors.
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Abstract
This study explores the dosimetric benefits of cone-beam computed tomography (CBCT)-based online adaptive radiation therapy (oART) for a non-small-cell lung cancer (NSCLC) patient exhibiting significant tumor shrinkage during ChemoRT. The patient was prescribed 60 Gray (Gy) in 30 fractions and was initially treated with conventional RT. After the delivery of the first four treatment fractions, the patient's treatment course was converted to oART due to tumor shrinkage seen on CBCT. Current oART dose calculations use a synthetic CT (sCT) image derived from deformable image registration (DIR) of the planning CT to the daily CBCT, and, as the tumor regressed, the discrepancy between the CBCT and the sCT increased, leading to a re-simulation after the delivery of the ninth fraction. In this case report, we first investigated dosimetric differences leveraged by converting this patient from conventional RT to oART. With oART using sCT, the patient's target coverage remained consistent with the reference plan while simultaneously changing lung V20 by 7.8 ± 1.4% and heart mean by 3.4 ± 1.5 Gy. Then, using this new simulation CT and comparing it with iterative CBCT (iCBCT) images acquired with the new HyperSight™ (HS) (Varian Medical Systems, Inc., Palo Alto, CA, USA) imaging system on the Ethos, we investigated the impact of direct dose calculation on HS-iCBCT as compared to sCT. The HS-iCBCT generated a dose distribution similar to the CT reference, achieving a 96.01% gamma passing rate using Task Group-218 (TG-218) criteria. Results indicate that HS-iCBCT has the potential to better reflect daily anatomical changes, resulting in improved dosimetric accuracy. This study highlights the advantages of oART in the presence of tumor response to therapy and underscores HS-iCBCT's potential to provide CT-level dose calculation accuracy in oART for NSCLC patients.
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