ArticleJournal of applied clinical medical physics2026
Accumulated dose on daily iCBCT for rectal cancer: Effects of inter-fraction bowel cavity motion volume.
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. Not yet cited in PubMed.
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Abstract
backgroundTo assess how inter-fraction bowel cavity (BC) motion volume influences accumulated dose in rectal cancer radiotherapy and to translate these effects into a clinically interpretable risk construct for acute bowel toxicity.
methodsThis retrospective cohort included 28 consecutive rectal cancer patients treated with 50 Gy in 25 fractions on a Halcyon v3.0 linac with daily iterative cone beam CT (iCBCT). Patients with > 5% bladder-volume or > 8% external-contour variation across the course were excluded. For each fraction, per-fraction dose was recalculated on the iCBCT using a scanner-specific HU-relative electron density calibration, rigidly aligned to the planning CT (pCT), deformably registered, and voxel-wise accumulated on pCT. Dosimetric endpoints were PTV D
resultsAccumulated dose analyses showed selective elevation of high-dose metrics with preservation of near-minimum target coverage. Compared with the plan, accumulated PTV D
conclusionDaily iCBCT-based dose accumulation identifies inter-fraction BC motion volume as a selective driver of high-dose escalation to the PTV and WB while largely preserving near-minimum target coverage. Accumulated WB V
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