Evidence map›Paper›PMID 41656965›Full record

ArticleJournal of applied clinical medical physics2026

Optimizing breast and chest wall treatment planning: Integrating dynamic collimator rotation with static-angle modulated ports in VMAT radiotherapy.

Emily Hubley, Yin Gao, Brandon Koger, Taoran Li, Kevin Risolo, Michael Salerno, Ryan M Scheuermann, Lei Dong, Boon-Keng Kevin Teo

Abstract read
In one paragraph

Article in Journal of applied clinical medical physics, 2026. 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

9 authors.

Emily HubleyDepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Yin GaoDepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Brandon KogerDepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Taoran LiDepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Kevin RisoloDepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Michael SalernoDepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Ryan M ScheuermannDepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Lei DongDepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Boon-Keng Kevin TeoDepartment of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRapidArc Dynamic (RAD) integrates static-angle modulated ports (STAMPs) and a dynamic collimator into arc delivery. The optimal use of RAD, including the ideal number of STAMPs, the best use of the dynamic collimator, and the ideal relative weighting between arc and STAMPs, has yet to be reported. We aim to investigate optimized utility of these parameters for breast and chest wall treatment planning to achieve superior dosimetric results.

methodsThirteen breast and chest wall patients were planned using RAD. Plans were created using the three different dynamic collimator options, five different arc/STAMP weighting options, and with 2, 4, and 6 STAMPs. All plans were created with automated skin flash. RAD plans were compared to conventional RapidArc (RA) plans. The DVH metrics and MUs for each plan were recorded, and a paired T-test was used to test for statistically significant (p ≤ 0.05) differences between the plans.

results"Optimize between static angles" was the best option for dynamic collimator setting. Increasing the number of STAMPs from 2 to 4 or 6 lowered PTV V105% in patients where the PTV V105% was high but provided limited benefit in most patients. Selecting arc-dominant weighting yields significantly worse DVH metrics than a balanced weighting. Dosimetric differences were minimal between (0) Balanced, (1) Static, or (2) Static-Dominant weighting.

conclusionsThe following are recommended as a starting point for breast and chest wall RAD plans: 2 STAMPs positioned similar to breast tangents, "optimize between static angles" for the dynamic collimator, and a weighting of either (0) balanced, (1) static, or (2) static-dominant. The arc-dominant setting resulted in plans of the lowest quality.

Indexed as

Breast NeoplasmsRadiotherapy, Intensity-ModulatedRadiotherapy Planning, Computer-AssistedThoracic NeoplasmsThoracic WallFemaleHumansOrgans at RiskPrognosisRadiotherapy DosageRotationbreastchest wallIMRTOAR sparingtreatment planningVMAT

Identifiers

PMID41656965
PMCPMC13671358

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.