Evidence map›Paper›PMID 40322202›Full record

ArticleCancer diagnosis & prognosis

Dosimetric Comparison of Coplanar, Non-coplanar, and Mixed-Arc VMAT for Head and Face Skin Cancers: A Multi-scenario Analysis.

Valentina Zagardo, Denis LA Fauci, Giuseppe Emmanuele Umana, Salvatore Lavalle, Paolo Palmisciano, Manfredi Noto, Andrea Boncoraglio, Gianluca Scalia, Gianluca Ferini

Abstract read
In one paragraph

Article in Cancer diagnosis & prognosis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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

  1. Pooled it
  2. 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

9 authors.

Valentina ZagardoDepartment of Radiation Oncology, REM Radioterapia srl, Viagrande, Italy.
Denis LA FauciDepartment of Radiation Oncology, REM Radioterapia srl, Viagrande, Italy.
Giuseppe Emmanuele UmanaDepartment of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy.
Salvatore LavalleDepartment of Medicine and Surgery, Kore University of Enna, Enna, Italy.
Paolo PalmiscianoDepartment of Neurological Surgery, University of California, Davis, Sacramento, CA, U.S.A.
Manfredi NotoNeurosurgical Unit, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy.
Andrea BoncoraglioRadiology Unit, Giovanni Paolo II Hospital, Ragusa, Italy.
Gianluca ScaliaDepartment of Medicine and Surgery, Kore University of Enna, Enna, Italy.
Gianluca FeriniDepartment of Radiation Oncology, REM Radioterapia srl, Viagrande, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background/Aim: This study compared dosimetric differences in target coverage and organs-at-risk (OARs) sparing among coplanar (co-VMAT), non-coplanar (nonco-VMAT), and mixed-arc (mxd-VMAT) volumetric modulated arc therapy (VMAT) for stereotactic radiation treatment of head and face skin cancers (HFSC). Patients and Methods: Five patients with HFSC, presenting with tumors located in critical areas near OARs were selected to represent distinct clinical scenarios. At least three competing VMAT plans per case (up to five for extensive tumors) were generated. The planning target volume (PTV) was obtained by applying a 1 mm isotropic expansion to the clinical target volume (CTV), except for portions extending beyond the body contour. Dosimetric parameters, including PTV indices [Dmax, D2%, D98%, V95%, conformity index (CI), and homogeneity index (HI)], dose to surrounding healthy tissues, beam-on time (BOT), and monitor units (MU) were evaluated and compared under identical optimization conditions. Results: Nonco-VMAT improved CI, HI, and OAR sparing for the first (left temporal-zygomatic) and third (nasal pyramid) patients. For the second patient (right frontal and zygomatic targets), mxd-VMAT was optimal for the frontal target, while nonco-VMAT was superior for the zygomatic target. Co-VMAT provided the highest plan quality for the fourth (occipital) patient, though mxd-VMAT slightly reduced OAR doses. For the fifth patient (scalp and vertex), co-VMAT achieved the best balance between target coverage and OAR sparing. Conclusion: This study highlights the potential benefits of non-coplanar arcs in HFSC treatment. VMAT arc arrangement should be tailored to tumor location, as the inclusion of non-coplanar arcs can enhance plan quality for both target coverage and OAR protection in specific cases. However, non-coplanar techniques may prolong treatment duration due to couch rotations and increased MU, potentially reducing patient tolerability.

Indexed as

cancercoplanarHead and facemixed-arcnon-coplanarradiotherapyskinVMAT

Identifiers

PMID40322202
PMCPMC12046653

What OpenQuestion holds

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Registered trials

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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.