Evidence map›Paper›PMID 39705230›Full record

ReviewDeutsches Arzteblatt international2025

Online Radiotherapy: The Paradigm Shift to Real-Time Adaptive Radiotherapy.

Goda Kalinauskaite, Konstantin Nikolaou, Andrea Wittig, Daniel Zips, Klaus Zöphel, Carolin Senger

Abstract readReview
In one paragraph

Review in Deutsches Arzteblatt international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–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

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Lanthanide Nanotheranostics in Radiotherapy.International journal of molecular sciences · 2025
    Review
  5. 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

6 authors.

Goda KalinauskaiteDepartment of Radiation Oncology and Radiotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Academy, Digital Clinician Scientist Program; Department of Diagnostic and Interventional Radiology, University Hospital Tübingen; Department of Radiotherapy and Radiooncology, University Hospital Würzburg; Department of Nuclear Medicine, Klinikum Chemnitz gGmbH.
Konstantin Nikolaou
Andrea Wittig
Daniel Zips
Klaus Zöphel
Carolin Senger

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAdaptive radiotherapy (ART) involves the continuous adaptation of the radiation plan according to patient- and tumorspecific feedback. In online ART, the plan is optimized in real time during the treatment; in offline ART, the plan is recalculated between treatment sessions. Hybrid linear accelerators with integrated CT, MRI, or PET are required to perform online ART.

methodsThis review is based on clinically relevant studies on online ART (January 2019 - May 2024) that were retrieved by a selective search in PubMed.

resultsOnline ART is a new technique for which no phase 3 trials have been published; in contrast, multiple randomized trials are already available for offline ART. The initial findings of a random - ized phase 2 trial of online ART for head and neck cancer showed lower rates of G2 or higher radiation-induced dermatitis (8% vs. 31%, p = 0.05) and a lower dose to the parotid gland (mean dose: 11.5 Gy vs. 16.0 Gy, p = 0.02) with online ART compared to standard radiochemotherapy. Moreover, observational studies show that online ART is feasible and spares organs at risk in patients with esophageal, pancreatic, rectal, and prostatic cancer. Additionally, online ART can enable simulation-free treatment planning and faster initiation of radiotherapy. It is, however, more demanding of time and resources and more costly than standard radiotherapy, and no studies with long-term clinical endpoints are available to date.

conclusionInitial studies confirm the feasibility of online ART and arouse the hope that it will enable more precise radiotherapy with less damage to surrounding structures. Phase 3 trials are needed so that the patient groups who stand to benefit most from online ART can be identified.

Indexed as

NeoplasmsRadiotherapy Planning, Computer-AssistedHumans

Identifiers

PMID39705230
PMCPMC12434711

What OpenQuestion holds

Textmetadata
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.