{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T20:40:59Z","timestamp":1792183259196,"version":"4.4.0"},"reference-count":46,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006364","name":"Institut National Du Cancer","doi-asserted-by":"publisher","award":["PHRC ARCOL"],"award-info":[{"award-number":["PHRC ARCOL"]}],"id":[{"id":"10.13039\/501100006364","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":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Plan\u2010of\u2010the\u2010day (PoD) adaptive radiation therapy (ART) is based on a library of treatment plans, with 3D daily imaging guiding the plan selection. In a phase II multi\u2010institutional trial of cone\u2010beam CT (CBCT)\u2010guided PoD\u2010ART for locally advanced cervical carcinoma (LACC), this study aimed at evaluating the PoD selection, its geometric and dosimetric impact and characterizing a sub\u2010population of patients associated with dosimetric improvement from ART.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>For 49 cervical cancer patients, three planning CT scans [empty bladder (EB), intermediate bladder (IB) and full bladder (FB)] were acquired to generate a treatment plan library. A dose of 45\u00a0Gy was prescribed to the planning target volume in 25 fractions. Daily CBCT were acquired to visually select the best plan in the library (Manual\u2010ART strategy). A deep learning model was used to segment daily clinical target volume (CTVt) and organs\u2010at\u2010risk (OAR). Manual\u2010ART was compared to two strategies: (i) \u201cNon\u2010ART\u201d strategy (IB\u2010CT treatment plan only); (ii) PoD\u2010ART strategy selecting the PoD maximizing CTVt coverage (\u201cCov\u2010ART\u201d). Geometrical and dosimetric coverages of daily CTVt and OAR were assessed. Decision trees were developed to predict the subpopulation of patients associated with dosimetric benefit from PoD\u2010ART.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The agreement in PoD selection between Manual\u2010ART and Cov\u2010ART was 63.5%. Compared to the Non\u2010ART strategy (D95%\u2010CTV: 43.6\u00a0\u00b1\u00a04.1\u00a0Gy), PoD\u2010ART significantly increased the dose to the target, with Manual\u2010ART achieving 44.0\u00a0\u00b1\u00a03.0\u00a0Gy and Cov\u2010ART with 44.1\u00a0\u00b1\u00a02.0\u00a0Gy. Decision trees using IB\u2010CT plan and first two treatment fractions correctly classified 85.4% and 93.8% of patients as benefiting or not from PoD\u2010ART.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In PoD\u2010ART for LACC, selected treatment plans by the radiation oncologist had 63.5% concordance with treatment plans maximizing target coverage. PoD\u2010ART increased dose to target, without compromising dose to OARs, with the largest benefit observed in a sub\u2010population identifiable after two treatment fractions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70356","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T03:07:42Z","timestamp":1763521662000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prospective multi\u2010institutional study of library\u2010based adaptive radiotherapy for cervical cancer: Evaluation of plan\u2010of\u2010the\u2010day selection and population analysis"],"prefix":"10.1002","volume":"26","author":[{"given":"Delphine","family":"Lebret","sequence":"first","affiliation":[{"name":"University of Rennes, CLCC Eug\u00e8ne Marquis, INSERM, LTSI \u2013 UMR 1099  Rennes 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