Page 72 - ARNM-2-4

Advances in Radiotherapy &

Nuclear Medicine

ORIGINAL RESEARCH ARTICLE
Dosimetric differences between online

adapt-to-position and offline adapt-to-shape
plans for adaptive radiotherapy in cervical

cancer

3
3†
2
2
Kaiwen Zhou 1,2† , Jinhu Chen , Junfeng Zhao , Xingwei An , Yong Yin *, and
Zhenjiang Li *
2
1 Department of Graduate, Shandong First Medical University (Shandong Academy of Medical
Sciences), Jinan, China
2 Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First
Medical University (Shandong Academy of Medical Sciences), Jinan City, Shandong, China
3 Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China

Abstract

Radiation therapy plays a significant role in the treatment of cervical cancer.
† These authors contributed equally
to this work. Additionally, more adaptive workflows using ATP are being implemented in the daily
radiotherapy of our organization. Herein, we aimed to investigate the dosimetric
*Corresponding authors:
Yong Yin differences between online ATP and offline ATS plans for magnetic resonance
(yinyongsd@126.com) (MR)-guided adaptive radiotherapy in patients with cervical cancer and determine
Zhenjiang Li
(lizhenjiang@email.sdfmu.edu.cn) radiotherapy modalities that address clinical requirements. In total, 25 patients with
cervical cancer were enrolled in this study, with 13 in the radical radiotherapy group
Citation: Zhou K, Chen J,
Zhao J, An X, Yin Y, Li Z. and 12 in post-operative radiotherapy group. We aimed for the clinical target volume
Dosimetric differences between (CTV) to be covered by 95 – 100% of the prescribed dose (50 Gy/25 sessions/5 weeks).
online adapt-to-position and MR-Linac was performed daily during treatment, and the images were rigidly aligned
offline adapt-to-shape plans for
adaptive radiotherapy in cervical with the local computed tomography to generate an online ATP plan. MR images
cancer. Adv Radiother Nucl Med. acquired during the first three sessions were selected to recontour the CTV and
2024;2(4):4919.
doi: 10.36922/arnm.4919 organs at risk (OAR). Furthermore, an offline ATS plan was generated. In the radical
radiotherapy group, the CTV, D98, D95 (5024.65 ± 23.34 vs. 4995.50 ± 14.99 cGy),
Received: September 23, 2024 and Dmean of the ATS were superior compared with those of the ATP. The Dmax
Accepted: December 10, 2024 was lower in the ATS plan than in the ATP plan. In the post-operative radiotherapy
Published Online: December 31, group, the CTV, Dmean, D98, and D95 (5052.61 ± 67.87 vs. 5014.41 ± 24.68 cGy) were
2024 better in the ATS plan than in the ATP plan. When evaluating the OAR in the radical
Copyright: © 2024 Author(s). radiotherapy group, the minimum doses to the bladder and rectum were greater
This is an Open-Access article in the ATS plan than in the ATP plan. In the post-operative radiotherapy group, the
distributed under the terms of the
Creative Commons Attribution V20 of the bladder and rectum were lower in the ATS plan than in the ATP plan.
License, permitting distribution, Therefore, ATS is well suited for post-operative radiotherapy, whereas ATP is better
and reproduction in any medium, suited for radical radiotherapy. Furthermore, ATP can effectively address the clinical
provided the original work is
properly cited. requirements of daily workflows.
Publisher’s Note: AccScience
Publishing remains neutral with Keywords: Online adaptive radiotherapy; Adapt-to-shape; Adapt-to-position; Cervical
regard to jurisdictional claims in
published maps and institutional cancer; Clinical target volume
affiliations

Volume 2 Issue 4 (2024) 1 doi: 10.36922/arnm.4919