Evidence map›Paper›PMID 40946222›Full record

ArticleJournal of applied clinical medical physics2025

The effect of interfractional variation on delivered dose with ultrahypofractionated pencil beam scanning proton therapy for localized prostate cancer.

Keyur D Shah, Duncan H Bohannon, Sagar A Patel, Chih-Wei Chang, Vishal R Dhere, Yinan Wang, Anees Dhabaan, Hania Al-Hallaq, Xiaofeng Yang, Jun Zhou

Abstract read
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In one paragraph

Article in Journal of applied clinical medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

1 citing paper in PubMed.

  1. 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

10 authors.

Keyur D ShahDepartment of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0002-0886-655X
Duncan H BohannonDepartment of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Sagar A PatelDepartment of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Chih-Wei ChangDepartment of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Vishal R DhereDepartment of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Yinan WangDepartment of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Anees DhabaanDepartment of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0002-6426-2443
Hania Al-HallaqDepartment of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Xiaofeng YangDepartment of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0001-9023-5855
Jun ZhouDepartment of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0002-6078-9424

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

PURPOSE/

objectivesProton stereotactic body radiotherapy (SBRT) using the pencil beam scanning (PBS) technique is increasingly used for localized prostate cancer (PCa) due to its potential for superior normal tissue sparing. However, interfractional anatomical variations pose challenges for accurate dose delivery, especially in ultrahypofractionation. This study investigates the dosimetric impact of these variations in PCa patients treated with PBS-SBRT.

methodsForty-two low- or intermediate-risk PCa patients treated with PBS-SBRT (36.25/ 40 Gy in 5 fractions) were included. Delivered doses were calculated by applying the initial plans to HU and artifact-corrected pre-treatment cone-beam computed tomography (CBCT) images. Dosimetric parameters were evaluated per fraction. Key anatomical features included clinical target volume (CTV) shifts in the superior-inferior (SI) and anterior-posterior (AP) directions, and volume changes in the bladder and rectum. These features were used to predict deviations in CTV D

resultsCTV AP shifts and bladder/rectum volume changes were significant predictors of dosimetric deviations. Univariate analyses indicated that bladder volume increases > 109.80 cc were strongly associated with deviations in CTV D

conclusionMultivariate models incorporating bladder volume changes and CTV shifts accurately predict dosimetric deviations in PBS-SBRT. These findings highlight the need for adaptive strategies during PBS-SBRT to mitigate the impact of interfractional variations, optimize dose delivery precision, and reduce toxicity in high-risk patients.

Indexed as

Organs at RiskProstatic NeoplasmsProton TherapyRadiosurgeryRadiotherapy Planning, Computer-AssistedAgedCone-Beam Computed TomographyHumansMaleMiddle AgedRadiotherapy DosageRadiotherapy, Intensity-ModulatedRetrospective StudiesUrinary Bladderinterfraction variationprostate cancerproton therapy

Identifiers

PMID40946222
PMCPMC12433594

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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.