Evidence map›Paper›PMID 42073535›Full record

ArticleCancers2026

Dosimetric Comparison of Automated Noncoplanar VMAT (HyperArc) Versus CyberKnife for Single-Fraction Vestibular Schwannoma Stereotactic Radiosurgery.

Zhenyu Xiong, Yin Zhang, Lili Zhou, Keying Xu, Xinxin Zhang, Loren Bell, Fredrick Warburton, David Huang, Sabin B Motwani, Charles S Cathcart and 3 more

Abstract read
In one paragraph

Article in Cancers, 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

13 authors.

Zhenyu XiongDepartment of Radiation Oncology, Rutgers Cancer Institute, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.ORCID 0000-0001-6905-5307
Yin ZhangDepartment of Radiation Oncology, Rutgers Cancer Institute, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.
Lili ZhouDepartment of Radiation Oncology, RWJBarnabas Health, West Orange, NJ 07052, USA.
Keying XuDepartment of Radiation Oncology, Rutgers Cancer Institute, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.ORCID 0000-0002-5408-0339
Xinxin ZhangDepartment of Radiation Oncology, Rutgers Cancer Institute, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.ORCID 0000-0003-3667-9302
Loren BellDepartment of Radiation Oncology, RWJBarnabas Health, West Orange, NJ 07052, USA.
Fredrick WarburtonDepartment of Radiation Oncology, RWJBarnabas Health, West Orange, NJ 07052, USA.
David HuangDepartment of Radiation Oncology, RWJBarnabas Health, West Orange, NJ 07052, USA.
Sabin B MotwaniRobert Wood Johnson Medical School, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.
Charles S CathcartDepartment of Radiation Oncology, RWJBarnabas Health, West Orange, NJ 07052, USA.
Ke NieDepartment of Radiation Oncology, Rutgers Cancer Institute, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.
Ning YueDepartment of Radiation Oncology, Rutgers Cancer Institute, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.
Xiao WangDepartment of Radiation Oncology, Rutgers Cancer Institute, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA.ORCID 0000-0003-1973-0313

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVestibular schwannoma (VS) stereotactic radiosurgery (SRS) requires high target conformality and rapid dose falloff to spare adjacent organs at risk (OARs), particularly the brainstem. HyperArc (HA) is an automated noncoplanar volumetric-modulated arc therapy (VMAT) approach designed to standardize and streamline cranial SRS planning and delivery. We compared CyberKnife (CK) with HA for single-fraction VS SRS and evaluated the impact of multileaf collimator (MLC) leaf width.

methodsFifteen VS cases previously treated with single-fraction CK SRS (12.5 Gy) were retrospectively replanned using HA. HA plans used four preconfigured noncoplanar partial arcs and were created with either a standard 5.0 mm MLC (HA-SMLC) or a 2.5 mm high-definition MLC (HA-HDMLC). HA plans were normalized to match the prescription dose target coverage of the corresponding CK plan for each of the patients. Endpoints included planning target volume (PTV) dosimetric statistics (Dmean, Dmin, Dmax, D98%), Paddick conformity index (PCI), Paddick gradient index (GI), ICRU Report 83 homogeneity index (HI), brain V12Gy, and brainstem Dmax. Because plans were generated for the same patients, paired comparisons were performed using two-sided Wilcoxon signed-rank tests (

resultsBoth HA techniques achieved a higher near-minimum target dose than CK, with significantly higher PTV D98% (CK 12.35 ± 0.52 Gy; HA-SMLC 12.54 ± 0.28 Gy; HA-HDMLC 12.57 ± 0.35 Gy;

conclusionsHA provides dosimetric performance comparable to CK for single-fraction VS SRS, with improved near-minimum PTV dose, reduced hotspots, and steeper dose gradients. Although CK showed the highest PCI overall, conformity improved with HA when a high-definition MLC was used. Overall, these findings support HA, particularly HA-HDMLC, as an efficient and clinically practical option for VS SRS treatment planning.

Indexed as

CyberKnifedosimetric comparisonhigh definition MLCHyperArcnoncoplanar VMATstereotactic radiosurgeryvestibular schwannoma

Identifiers

PMID42073535
PMCPMC13114464

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.