TY  - JOUR
AU  - Khouya, Aymane
AU  - Santiago, Alina
AU  - Ringbaek, Toke
AU  - Guberina, Nika
AU  - Guberina, Maja
AU  - Gauler, Thomas
AU  - Lübcke, Wolfgang
AU  - Zylka, Waldemar
AU  - Pöttgen, Christoph
AU  - Stuschke, Martin
TI  - 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?
JO  - Radiation oncology
VL  - 20
IS  - 1
SN  - 1748-717X
CY  - London
PB  - BioMed Central
M1  - DKFZ-2025-01019
SP  - 75
PY  - 2025
AB  - 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
KW  - Humans
KW  - Radiotherapy Planning, Computer-Assisted: methods
KW  - Lung Neoplasms: radiotherapy
KW  - Lung Neoplasms: pathology
KW  - Radiotherapy, Intensity-Modulated: methods
KW  - Radiotherapy Dosage
KW  - Cone-Beam Computed Tomography: methods
KW  - Algorithms
KW  - Prospective Studies
KW  - Male
KW  - Organs at Risk: radiation effects
KW  - Female
KW  - Aged
KW  - Middle Aged
LB  - PUB:(DE-HGF)16
C6  - pmid:40375212
C2  - pmc:PMC12082940
DO  - DOI:10.1186/s13014-025-02656-1
UR  - https://inrepo02.dkfz.de/record/301477
ER  -