ArticleJournal of applied clinical medical physics2026
Dosimetric effects of internal margin, auto flash, and virtual bolus in VMAT-based whole-breast radiotherapy under motion variations.
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.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
background and purposeThis study aimed to evaluate the dosimetric performance and robustness of volumetric modulated arc therapy (VMAT) planning techniques-planning target volume with internal margin (INT), auto flash (AF), and virtual bolus (VB)-under simulated geometric changes during whole-breast radiotherapy.
methodsNine patients with left-sided breast cancer were included. Three planning techniques were compared: INT with a 5-mm skin-sparing internal margin, AF with a 1-cm automatic skin flash margin, and VB with a 5-mm optimization bolus applied only during the planning. Respiratory motion was simulated by shifting the plan center (± 3 mm and ± 5 mm) and recalculating the dose distributions.
resultsUnder static conditions, all plans provided adequate target coverage, with planning target volume (PTV) V95% values of 96.45% (INT), 97.35% (AF), and 98.19% (VB). Under breast swelling of up to 5 mm, AF maintained the most stable coverage (PTV V95% = 99.10%), outperforming VB (95.02%) and INT (92.31%) (p < 0.001). In simulated incomplete inspiration (5 mm), VB showed superior robustness, achieving a PTV V95% of 90.46% compared with AF (85.30%) and INT (85.08%) (p = 0.008). AF met the ideal criteria in all cases under swelling conditions, whereas the VB was more effective against suboptimal respiration.
conclusionsIn VMAT breast radiation therapy (RT), the conventional INT approach was the least robust against variations, and additional techniques are required. AF effectively compensates for breast swelling, whereas VB preserves the target coverage under insufficient breath-hold conditions. Surface-guided radiation therapy (SGRT) and visual guidance are recommended to ensure accurate treatment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.