%0 Journal Article
%A Khouya, Aymane
%A Santiago, Alina
%A Ringbaek, Toke
%A Guberina, Nika
%A Guberina, Maja
%A Gauler, Thomas
%A Lübcke, Wolfgang
%A Zylka, Waldemar
%A Pöttgen, Christoph
%A Stuschke, Martin
%T Are treatment plans optimized on the basis of acuros XB dose calculation robust against anatomic changes during online adaptive radiotherapy for lung cancer regarding dose homogeneity?
%J Radiation oncology
%V 20
%N 1
%@ 1748-717X
%C London
%I BioMed Central
%M DKFZ-2025-01019
%P 75
%D 2025
%X The Acuros XB dose calculation algorithm implements advanced modelling of lateral electron transport, making dose distributions sensitive to density changes between source and subsequent CT. The aim of this study was to analyse the robustness of dose distribution in the central bronchial wall (CBW) of treatment plans from lung cancer patients treated with adaptive radiotherapy.IMRT or VMAT plans from patients with locally advanced lung cancer from a prospective registry cohort were analysed, who received definitive radiotherapy in surface-guided inspiratory breath-hold on the Ethos™ closed-bore linac, equipped with the HyperSight™ cone beam CT (CBCT). Dose homogeneity of the scheduled plans, optimized on planning CT (CTplan), was verified on the initial CBCT of a dose fraction (CBCT1). The adaptive plans were verified on a subsequent post-adaptation CBCT (CBCT2) of the same dose fraction. A predictive model was built for maximum dose (Dmax) in CBW in dependence on plan sensitivity in the central bronchial air lumen overlapping the planning target volume (CBALPTV) to water override (WOR) of the air lumen.Ninety-one dose-fractions from 10 patients were analysed. Dmax values in the CBW of the scheduled plans showed over all significant inter-fractional increases from CTplan to subsequent CBCT1 (p < 0.0001, Wilcoxon test, stratified by patient) with significant heterogeneity between patients (p < 0.0001, Kruskal-Wallis Test). The median Dmax increase per dose fraction was 2.15
%K Humans
%K Radiotherapy Planning, Computer-Assisted: methods
%K Lung Neoplasms: radiotherapy
%K Lung Neoplasms: pathology
%K Radiotherapy, Intensity-Modulated: methods
%K Radiotherapy Dosage
%K Cone-Beam Computed Tomography: methods
%K Algorithms
%K Prospective Studies
%K Male
%K Organs at Risk: radiation effects
%K Female
%K Aged
%K Middle Aged
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:40375212
%2 pmc:PMC12082940
%R 10.1186/s13014-025-02656-1
%U https://inrepo02.dkfz.de/record/301477