{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:27:42Z","timestamp":1794324462311,"version":"4.9.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To determine whether a dual\u2010isocenter volumetrically modulated arc therapy (VMAT) technique results in lower normal pulmonary dosage compared to a traditional single isocenter technique for boot\u2010shaped lung cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort of 15 patients with advanced peripheral or central lung cancer who had metastases in the mediastinum and supraclavicular lymph nodes was randomly selected for this retrospective study. VMAT plans were generated for each patient using two different beam alignment techniques with the 6\u2010MV flattening filter\u2010free (FFF) photon beam: single\u2010isocenter jaw\u2010tracking VMAT based on the Varian TrueBeam linear accelerator (S\u2010TV), and dual\u2010isocenter VMAT based on both TrueBeam (D\u2010TV) and Halcyon linear accelerator (D\u2010HV). For all 45 treatment plans, planning target volume (PTV) dose coverage, conformity\/homogeneity index (CI\/HI), mean heart dose (MHD), mean lung dose (MLD) and the total lung tissue receiving 5, 20, 30\u00a0Gy (V<jats:sub>5<\/jats:sub>, V<jats:sub>20<\/jats:sub>, V<jats:sub>30<\/jats:sub>) were evaluated. The monitor units (MUs), delivery time, and plan quality assurance (QA) results were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The quality of the objectives of the three plans was comparable to each other. In comparison with S\u2010TV, D\u2010TV and D\u2010HV improved the CI and HI of the PTV (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05). The MLD was 13.84\u00a0\u00b1\u00a01.44\u00a0Gy (mean\u00a0\u00b1\u00a0SD) for D\u2010TV, 14.22\u00a0\u00b1\u00a01.30\u00a0Gy and 14.16\u00a0\u00b1\u00a01.42\u00a0Gy for S\u2010TV and D\u2010HV, respectively. Lungs\u2010V<jats:sub>5Gy<\/jats:sub> was 50.78\u00a0\u00b1\u00a06.24%, 52.00\u00a0\u00b1\u00a07.32% and 53.36\u00a0\u00b1\u00a08.48%, Lungs\u2010V<jats:sub>20Gy<\/jats:sub> was 23.72\u00a0\u00b1\u00a02.27%, 26.18\u00a0\u00b1\u00a02.86% and 24.96\u00a0\u00b1\u00a03.09%, Lungs\u2010V30Gy was 15.69\u00a0\u00b1\u00a01.76%, 17.20\u00a0\u00b1\u00a01.72% and 16.52\u00a0\u00b1\u00a02.07%. Compared to S\u2010TV, D\u2010TV provided statistically significant better protection for the total lung, with the exception of the lungs\u2010V<jats:sub>5<\/jats:sub>. All plans passed QA according the gamma criteria of 3%\/3\u00a0mm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Taking into account the dosimetric results and published clinical data on radiation\u2010induced pulmonary injury, dual\u2010isocenter jaw\u2010tracking VMAT may be the optimal choice for treating boot\u2010shaped lung cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.14292","type":"journal-article","created":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T22:09:37Z","timestamp":1706566177000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Single isocenter versus dual isocenter treatment using flattening filter\u2010free and jaw\u2010tracking volumetrically modulated arc therapy for boot\u2010shaped lung cancer: Evaluation of dosimetric and feasibility"],"prefix":"10.1002","volume":"25","author":[{"given":"Lei","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Radiation Physics Zhejiang Cancer Hospital  Hangzhou Zhejiang China"},{"name":"Hangzhou Institute of Medicine(HIM) Chinese Academy of Sciences  Hangzhou Zhejiang China"},{"name":"Radiotherapy Technology Department Yuyao People's Hospital of Zhejiang Province  NingBo Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Cheng","sequence":"additional","affiliation":[{"name":"Radiotherapy Technology Department Yuyao People's Hospital of Zhejiang Province  NingBo Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenglei","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics Zhejiang Cancer Hospital  Hangzhou Zhejiang China"},{"name":"Hangzhou Institute of Medicine(HIM) Chinese Academy of Sciences  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kainan","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics Zhejiang Cancer Hospital  Hangzhou Zhejiang China"},{"name":"Hangzhou Institute of Medicine(HIM) Chinese Academy of Sciences  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiming","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics Zhejiang Cancer Hospital  Hangzhou Zhejiang China"},{"name":"Hangzhou Institute of Medicine(HIM) Chinese Academy of Sciences  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiwei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics Zhejiang Cancer Hospital  Hangzhou Zhejiang China"},{"name":"Hangzhou Institute of Medicine(HIM) Chinese Academy of Sciences  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoping","family":"Shan","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics Zhejiang Cancer Hospital  Hangzhou Zhejiang China"},{"name":"Hangzhou Institute of Medicine(HIM) Chinese Academy of Sciences  Hangzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,29]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000002108"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2020.05.023"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2021.08.1994"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.06.1963"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.69.1378"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2010.06.025"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2022.05.007"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2016.10.001"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/0973-1482.138217"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20190535"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12032-015-0546-6"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v14i3.4269"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13416"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1088\/2057-1976\/ac2f0d"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2020.12.004"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2021.11.030"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2017.11.006"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2019.01456"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2018.02.023"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.07.012"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00066-011-0015-x"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2012.04.043"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(01)01685-6"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000187"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.09.030"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2023.01.005"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2021.01.002"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12747"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/acae18"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.14292","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T18:13:36Z","timestamp":1718216016000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.14292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,29]]},"references-count":30,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/acm2.14292"],"URL":"https:\/\/doi.org\/10.1002\/acm2.14292","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,29]]},"assertion":[{"value":"2023-10-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14292"}}