Evidence map›Paper›PMID 41050918›Full record

ArticleAdvances in radiation oncology2025

HyperArc Automated Stereotactic Radiosurgery Planning Enables Accurate a Priori Fractionation Scheme Selection via Adherence to HyTEC Toxicity Thresholds.

Joel A Pogue, John Fiveash, Rex Cardan, Christopher Willey, Natalie Viscariello, Rodney Sullivan, Samuel Marcrom, Luke Moradi, Philip Schmalz, James Markert and 1 more

Abstract read
In one paragraph

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 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

11 authors.

Joel A PogueDepartment of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, Alabama.
John FiveashDepartment of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, Alabama.
Rex CardanDepartment of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, Alabama.
Christopher WilleyDepartment of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, Alabama.
Natalie ViscarielloDepartment of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, Alabama.
Rodney SullivanDepartment of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, Alabama.
Samuel MarcromDepartment of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, Alabama.
Luke MoradiDepartment of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, Alabama.
Philip SchmalzDepartment of Neurosurgery, The University of Alabama at Birmingham, Birmingham, Alabama.
James MarkertDepartment of Neurosurgery, The University of Alabama at Birmingham, Birmingham, Alabama.
Richard PoppleDepartment of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, Alabama.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Radiosurgery plan safety is commonly estimated by volumes receiving specific doses (ie, 12 Gy/1 fraction [fx]), which are evaluated postplan generation. However, automated treatment planning can produce highly consistent and thus predictable plans. Thus, we hypothesized that HyperArc (HA) automated stereotactic radiosurgery (SRS) planning enables clinical decision-making prior to plan generation, such as selecting the appropriate SRS fractionation scheme. Methods and Materials: All previously treated single-isocenter HA plans at our institution were queried, totaling 3361 marginless targets without bridging at the 50% isodose level (1495 plans), making this the largest single-institutional SRS dosimetry study to the authors' knowledge. Eight isodose volumes (IDVs; 50.00%-97.60%) were calculated for all HA targets, each corresponding to the ratio of a High Dose per Fraction, Hypofractionated Treatment Effects in the Clinic (HyTEC) brain toxicity dose level and a common prescription dose (eg, 50.00% = 12 Gy/24 Gy). Power law relationships of IDV and target volume ( Results: Models resulted in high R² values when applied to the validation cohort (≥0.982), allowing targets to be classified as either above or below the HyTEC thresholds (IDV = 5 cm Conclusion: The resulting models enabled accurate and precise prediction of target volumes/diameters, resulting in 3.6%, 4.8%, and 8.6% brain grade 1 to 3 toxicity rates, according to HyTEC toxicity estimates. Leveraging relative IDVs rather than prescription doses enabled all 3361 targets to be used for modeling 9 common SRS prescriptions (1 fx: 24 Gy, 20 Gy, 18 Gy, 16 Gy, and 15 Gy; 3 fx: 27 Gy and 24 Gy; 5 fx: 30 Gy and 25 Gy), enabling clinicians to estimate brain toxicity a priori via an open-source calculator.

Identifiers

PMID41050918
PMCPMC12494823

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