ArticleJournal of applied clinical medical physics2026
Adapt-on-demand: Enabling flexible and scalable adaptive radiotherapy through workflow automation.
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.
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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.
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Who cites it
1 citing paper in PubMed.
- Adapt-on-demand: Enabling flexible and scalable adaptive radiotherapy through workflow automation.Journal of applied clinical medical physics · 2026Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
purposeCT-guided adaptive radiotherapy (CTgART) offers significant clinical benefits, but its utilization is often limited by resource demands and rigid workflows. This study presents a flexible and scalable "Adapt-on-Demand" (AOD) framework that integrates the adaptive capabilities of the Varian Ethos platform with the high-throughput IGRT delivery of the Varian Halcyon, supported by automated scripting.
methodsWe developed an end-to-end dual-platform workflow that dynamically transitions between ART and IGRT delivery based on patient needs. Key components include Eclipse Scripting API (ESAPI) automation to streamline adapted plan ingestion from the Ethos Treatment Planning and Management System (TPMS) export directory, compatibility conversion for Halcyon delivery, and ARIA chart setup. The framework was evaluated through time-efficiency analysis and longitudinal tracking of ART utilization and machine throughput. Multi-institutional deployment was also conducted to validate generalizability.
resultsAutomation reduced plan setup time from 45 to 8 min (p < 0.001, unpaired t-test), and direct comparison of MLC leaf positions confirmed exact agreement between Ethos-native and converted plans across all control points. ART utilization on the Ethos platform increased from 17% to 77% following IGRT offloading to Halcyon. The workflow was successfully implemented at two external sites without code modification, demonstrating portability.
conclusionThis AOD framework enables flexible ART delivery without compromising workflow efficiency. By automating inter-platform transitions and alleviating adaptive system burden, it improves clinical throughput and broadens patient access to ART. This work also underscores the importance of system interoperability and provides a scalable model adaptable across diverse practice settings.
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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.