Evidence map›Paper›PMID 42449263›Full record

ArticleBMC cancer2026

Risk stratification and cross-center prediction of thoracoabdominal 6D setup errors.

Weixiang Lin, Dongming Xie, Yongwen Fang, Lei Wang, Shipei Lu, Xiaosheng Lin, Jianlan Fang, Chengjian Xiao, Liangjie Xiao

Abstract readMulticenter Study
In one paragraph

Article in BMC cancer, 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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1 · What the graph read from it

What it found

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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.

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

9 authors.

Weixiang Lin *Department of Radiation Oncology, Ganzhou Cancer Hospital, Ganzhou, 341000, People's Republic of China.
Dongming Xie *Department of Radiation Oncology, Ganzhou Cancer Hospital, Ganzhou, 341000, People's Republic of China.
Yongwen Fang *State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China.
Lei WangDepartment of Radiation Oncology, Rizhao Central Hospital, Rizhao, 276800, The People's Republic of China.
Shipei LuState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China.
Xiaosheng LinState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China.
Jianlan FangState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China. fangjl@sysucc.org.cn.
Chengjian XiaoDepartment of Radiation Oncology, Ganzhou Cancer Hospital, Ganzhou, 341000, People's Republic of China. xiaocj1995@126.com.
Liangjie XiaoState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, 510060, P. R. China. xiaolj@sysucc.org.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThoracoabdominal CBCT-derived six-degree-of-freedom (6DoF) setup errors vary substantially across centers. Using record-level setup events as the unit of analysis, we examined whether pre-treatment workflow variables could stratify the risk of large translational events, how they performed for infrequent rotational events, and whether model performance held up across centers.

methodsThis retrospective two-center cohort study included CBCT-derived 6DoF setup records collected during 2022-2025 at Center 1 and 2020-2022 at Center 2. After exact matching and deduplication, 6,033 unique records were retained from the original 6,584 records. The primary endpoint was three-dimensional composite translational displacement ≥ 5 mm (Y5mm), calculated using tvec. Secondary endpoints were tvec ≥ 10 mm (Y10mm), maximum rotational magnitude (rmax) ≥ 3° (R3°), and the composite endpoint Yaction, defined as either Y5mm or R3°. Center, anatomic site, tumor type, and immobilization method were used as predictors. CatBoost and XGBoost were evaluated with three-fold stratified cross-validation and bidirectional cross-center external validation.

resultsEvent rates for Y5mm, Y10mm, R3°, and Yaction were 39.3%, 6.1%, 5.4%, and 40.9%, respectively. Key endpoint rates differed significantly between centers, suggesting marked domain shift. In internal validation, CatBoost and XGBoost performed similarly for Y5mm (AUPRC, 0.620 and 0.622, respectively), whereas prediction of R3° was limited. In bidirectional cross-center validation, performance for the primary and composite endpoints declined compared with internal validation and showed asymmetric transfer patterns. Calibration also worsened externally. SHAP analysis identified immobilization method as one of the most important features for Y5mm.

conclusionThoracoabdominal CBCT-derived 6DoF setup errors show clear risk stratification patterns and substantial cross-center heterogeneity. Models based on pre-treatment workflow variables provided modest stratification for large translational events, but were less useful for rare large rotational events. For workflow deployment, local recalibration at the target center may be preferable to direct transfer of raw predicted probabilities.

Indexed as

Abdominal NeoplasmsCone-Beam Computed TomographyRadiotherapy Planning, Computer-AssistedRadiotherapy Setup ErrorsThoracic NeoplasmsHumansRadiotherapy, Image-GuidedRetrospective StudiesRisk AssessmentCone-beam computed tomographyCross-center predictionRisk stratificationSix-degree-of-freedom setup errorThoracoabdominal radiotherapy

Identifiers

PMID42449263
PMCPMC13670848

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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.