TY  - JOUR
AU  - Guberina, Maja
AU  - Santiago Garcia, Alina
AU  - Khouya, Aymane
AU  - Pöttgen, Christoph
AU  - Holubyev, Kostyantyn
AU  - Ringbaek, Toke Printz
AU  - Lachmuth, Manfred
AU  - Alberti, Yasemin
AU  - Hoffmann, Christian
AU  - Hlouschek, Julian
AU  - Gauler, Thomas
AU  - Lübcke, Wolfgang
AU  - Indenkämpen, Frank
AU  - Stuschke, Martin
AU  - Guberina, Nika
TI  - Comparison of Online-Onboard Adaptive Intensity-Modulated Radiation Therapy or Volumetric-Modulated Arc Radiotherapy With Image-Guided Radiotherapy for Patients With Gynecologic Tumors in Dependence on Fractionation and the Planning Target Volume Margin.
JO  - JAMA network open
VL  - 6
IS  - 3
SN  - 2574-3805
CY  - Chicago, Ill.
PB  - American Medical Association
M1  - DKFZ-2023-00584
SP  - e234066
PY  - 2023
AB  - Patients with newly diagnosed locally advanced cervical carcinomas or recurrences after surgery undergoing radiochemotherapy whose tumor is unsuited for a brachytherapy boost need high-dose percutaneous radiotherapy with small margins to compensate for clinical target volume deformations and set-up errors. Cone-beam computed tomography-based online adaptive radiotherapy (ART) has the potential to reduce planning target volume (PTV) margins below 5 mm for these tumors.To compare online ART technologies with image-guided radiotherapy (IGRT) for gynecologic tumors.This comparative effectiveness study comprised all 7 consecutive patients with gynecologic tumors who were treated with ART with artificial intelligence segmentation from January to May 2022 at the West German Cancer Center. All adapted treatment plans were reviewed for the new scenario of organs at risk and target volume. Dose distributions of adapted and scheduled plans optimized on the initial planning computed tomography scan were compared.Online ART for gynecologic tumors.Target dose coverage with ART compared with IGRT for PTV margins of 5 mm or less in terms of the generalized equivalent uniform dose (gEUD) without increasing the gEUD for the organs at risk (bladder and rectum).The first 10 treatment series among 7 patients (mean [SD] age, 65.7 [16.5] years) with gynecologic tumors from a prospective observational trial performed with ART were compared with IGRT. For a clinical PTV margin of 5 mm, IGRT was associated with a median gEUD decrease in the interfractional clinical target volume of -1.5
LB  - PUB:(DE-HGF)16
C6  - pmid:36947038
DO  - DOI:10.1001/jamanetworkopen.2023.4066
UR  - https://inrepo02.dkfz.de/record/274417
ER  -