ArticleAdvances in radiation oncology2025
Assessing Dosimetric Benefits of Cone Beam Computed Tomography-Guided Online Adaptive Radiation Treatment Frequencies for Lung Cancer.
Article in Advances in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Does the traffic light protocol capture dose deviations? A longitudinal CBCT-based dose-monitoring study in adaptive RT for LA-NSCLC.Technical innovations & patient support in radiation oncology · 2026Article
- Development of CBCT-Guided Online Adaptive Radiotherapy.Cancers · 2026Review
- Adapt-on-demand: Enabling flexible and scalable adaptive radiotherapy through workflow automation.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 High-Fidelity Mode for Improved Online Adaptive Stereotactic Accelerated Partial Breast Treatment Efficiency.Advances in radiation oncology · 2025Article
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Authors and funding
11 authors.
Funding
Abstract
Purpose: Online adaptive radiation therapy (oART) has shown the ability to diminish interfraction variations. However, oART is a time- and labor-intensive process, and the optimal adaptation frequency remains to be determined for lung cancer oART. The purpose of this study was to quantify and assess dosimetric benefits associated with various adaptive frequencies in patients with lung cancer receiving oART. Methods and Materials: This study included 8 patients with lung cancer receiving oART treated on the Ethos platform in 30 or 33 fractions (n = 7 /1). For a total of 243 fractions, daily contours on cone-beam computed tomography (CT) and adaptive/nonadaptive plans on synthetic CT scan were used to simulate 4 different adaptation frequencies: none, single, weekly, and daily adaptation, resulting in 972 unique dose distributions. Dose-volume-histograms of targets and organs-at-risk (OARs) were compared between adaptation frequencies. Besides Dose-volume-histogram analysis, 3 radiation oncologists reviewed and scored 185 total plans, evenly sampling plans from the various adaptive frequencies. A comprehensive plan scorecard was fine-tuned to correlate with physician reviews and subsequently used for interplan comparison. Results: Compared with no adaptation, daily adaptation improved the median clinical target volume V100% by 0.2% (IQR, 0.0-1.0) and the planning target volume D98% by 0.5% (IQR, -2.2 to 3.83). It also reduced the planning target volume D0.03cc by 2.1% (IQR, 0.7-3.2), the lungs-internal target volume V20 Gy by 2.5% (IQR, 1.0-4.5), the heart D Conclusions: Online kilovoltage cone-beam CT scan-guided daily adaptation may lead to dosimetric benefits in both target coverage and OAR sparing in patients with lung cancer. Other adaptation frequencies are effective for some patients but tend to lead to target undercoverage compared with daily adaptation.
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Registered trials
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