{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:45:05Z","timestamp":1791362705705,"version":"4.3.1"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T00:00:00Z","timestamp":1631750400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007210","name":"Varian Medical Systems","doi-asserted-by":"publisher","award":["VUMC74894"],"award-info":[{"award-number":["VUMC74894"]}],"id":[{"id":"10.13039\/100007210","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This provides a benchmark of dosimetric benefit and clinical cost of cone\u2010beam CT\u2010based online adaptive radiotherapy (ART) technology for cervical and rectal cancer patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An emulator of a CBCT\u2010based online ART system was used to simulate\u00a0more than\u00a0300 treatments for 13 cervical and 15 rectal cancer patients. CBCT images were used to generate adaptive replans. To measure clinical resource cost, the six phases of the workflow were timed. To evaluate the dosimetric benefit, changes in dosimetric values were assessed. These included minimum dose (Dmin) and volume receiving 95% of prescription (V95%) for the planning target volume (PTV) and the clinical target volume (CTV), and maximum 2 cc's (D2cc) of the bladder, bowel, rectum, and sigmoid colon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average duration of the workflow was 24.4 and 9.2\u00a0min for cervical and rectal cancer patients, respectively. A large proportion of time was dedicated to editing target contours (13.1 and 2.7\u00a0min, respectively). For cervical cancer patients, the replan changed the Dmin to the PTVs and CTVs for each fraction 0.25 and 0.25\u00a0Gy, respectively. The replan changed the V95% by 9.2 and 7.9%. The D2cc to the bladder, bowel, rectum, and sigmoid colon for each fraction changed \u22120.02, \u22120.08, \u22120.07, and \u22120.04\u00a0Gy, respectively. For rectal cancer patients, the replan changed the Dmin to the PTVs and CTVs for each fraction of 0.20 and 0.24\u00a0Gy, respectively. The replan changed the V95% by 4.1 and 1.5%. The D2cc to the bladder and bowel for each fraction changed 0.02 and \u22120.02\u00a0Gy, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Dosimetric benefits can be achieved with CBCT\u2010based online ART that is amenable to conventional appointment slots. The clinical significance of these benefits remains to be determined. Managing contours was the primary factor affecting the total duration and is imperative for safe and effective adaptive radiotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.13425","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T15:30:27Z","timestamp":1631806227000},"page":"210-221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Initial analysis of the dosimetric benefit and clinical resource cost of CBCT\u2010based online adaptive radiotherapy for patients with cancers of the cervix or rectum"],"prefix":"10.1002","volume":"22","author":[{"given":"Adam D.","family":"Yock","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diandra","family":"Ayala\u2010Peacock","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Department of Radiation Oncology Duke University Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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