ArticleWorld journal of clinical oncology2025
Impact evaluation of intra-fractional variation on online adaptive radiotherapy for postoperative cervical and endometrial cancer.
Article in World journal of clinical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Article
- Platform-specific comparison of IMRT and VMAT angular resolution for Ethos-based online adaptive radiotherapy in cervical cancer.Frontiers in oncology · 2026Article
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7 authors.
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Abstract
backgroundOnline adaptive radiotherapy (oART) has demonstrated improved target volume coverage and enhanced sparing of surrounding pelvic organs through daily re-optimization based on pretreatment imaging. Recently, iterative cone-beam computed tomography (iCBCT) has been integrated into oART workflows, facilitating precise daily adaptation. However, the dosimetric consequences of intra-fractional variations for clinical target volume (CTV) and organs at risk (OARs) remain insufficiently characterized.
aimTo investigate intra-fractional CTV and OARs variation and their impact on iCBCT guided daily oART for postoperative cervical and endometrial cancer.
methodsSeventeen patients treated with daily postoperative iCBCT guided oART with rigorous bladder and rectal preparation protocols were enrolled. CTV and OARs were contoured on pre- and post-treatment iCBCT scans. The average surface distance (ASD), dice similarity coefficient (DSC), and 95% Hausdorff distance (HD) were utilized to evaluate the difference between pre- and post-treatment structures. Dosimetric outcomes for the pretreatment target volumes and OARs were recalculated using posttreatment contours to assess the impact of intra-fractional variation.
resultsA total of 434 treatment fractions were analyzed, with an average interval time of 22 minutes between two iCBCT scans. Minimal variations were observed in the bladder, rectum, and CTV both pre- and post-treatment, with DSC exceeding 0.8. The vaginal CTV exhibited centroid deviations of 0.46 mm anteriorly, 0.11 mm laterally, and 0.58 mm superiorly, along with ASD of 1.69 mm and 95% HD of 6.42 mm. Weak correlations were observed between vaginal CTV posterior-anterior centroid deviations and rectal superior-inferior deviations (
conclusionDaily iCBCT-guided oART with strict bladder and rectal preparation effectively compensates for intra-fractional variations, maintaining CTV coverage and OAR sparing across all treatment fractions.
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