ArticleRadiation oncology (London, England)2026
Optimizing ovarian dose sparing for young cervical cancer patients after oophoropexy: a dosimetric and radiobiological comparison of three radiotherapy techniques (IMPT, TOMO, and VMAT).
Article in Radiation oncology (London, England), 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
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo systematically compare the dosimetric performance and model-based radiobiological estimates of intensity-modulated proton therapy (IMPT), helical tomotherapy (TOMO), and volumetric modulated arc therapy (VMAT) for ovarian dose sparing in young cervical cancer patients after oophoropexy.
methodsTen premenopausal cervical cancer patients who received postoperative pelvic radiotherapy following bilateral ovarian transposition were retrospectively enrolled. Three treatment plans (IMPT, TOMO, and VMAT) were designed for each patient with a uniform prescription of 45 Gy in 25 fractions. IMPT plans incorporated robust optimization accounting for setup uncertainty (5 mm) and range uncertainty (3.5%). Dosimetric parameters evaluated included target coverage ([Formula: see text]), homogeneity index (HI), ovarian mean dose ([Formula: see text]) and maximum dose ([Formula: see text]), and dose-volume metrics for organs at risk (OARs: rectum, bladder, small intestine, sigmoid, femoral heads). Radiobiological analyses included equivalent uniform dose (EUD), normal tissue complication probability (NTCP), and excess absolute risk (EAR) estimation for secondary malignancies using Schneider's mechanistic model.
resultsAll three techniques achieved clinically acceptable target coverage. IMPT showed superior dose homogeneity and the most favorable planned ovarian dose-sparing profile, reducing ovarian [Formula: see text] by approximately 95% compared with photon-based techniques (0.11-0.35 Gy vs. 4.44-5.24 Gy, [Formula: see text]) and substantially lowering low-dose exposure ([Formula: see text] cc vs. 2.86-7.68 cc, [Formula: see text]). Both IMPT and TOMO achieved significantly lower [Formula: see text] to the rectum, bladder, and small intestine than VMAT ([Formula: see text]). IMPT also reduced small intestine [Formula: see text], mean bladder dose, and integral dose to normal tissue compared with both photon techniques ([Formula: see text]). Model-based NTCP analysis showed that IMPT yielded lower estimated complication probabilities for the small intestine, rectum, and bladder compared with TOMO and VMAT ([Formula: see text]), while femoral head estimates were comparable between IMPT and VMAT and lower than TOMO. EAR modeling suggested organ-specific and endpoint-dependent differences across pelvic OARs. VMAT had the shortest beam-on time (2.20 ± 0.05 min vs. TOMO 8.18 ± 0.99 min, [Formula: see text]).
conclusionIMPT achieved the lowest ovarian radiation exposure and the most favorable overall dosimetric profile for ovarian dose sparing after ovarian transposition. TOMO provided competitive sparing for several high-dose pelvic OAR endpoints, whereas VMAT offered the shortest photon beam-on time. Overall, IMPT appears to be the most favorable dosimetric option for ovarian dose sparing when available, while VMAT and TOMO remain reasonable alternatives depending on clinical priorities and resource availability. These findings should be interpreted as dosimetric and model-based advantages rather than direct evidence of improved ovarian endocrine function or reduced clinical toxicity.
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.