{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:54:03Z","timestamp":1791986043910,"version":"4.4.0"},"reference-count":13,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T00:00:00Z","timestamp":1770508800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>RapidArc Dynamic (RAD) integrates static\u2010angle modulated ports\u00a0(STAMPs) and a dynamic collimator into arc delivery. The optimal use of RAD, including the ideal number of STAMPs, the best use of the dynamic collimator, and the ideal relative weighting between arc and STAMPs, has yet to be reported. We aim to investigate optimized utility of these parameters for breast and chest wall treatment planning to achieve superior dosimetric results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Thirteen breast and chest wall patients were planned using RAD. Plans were created using the three different dynamic collimator options, five different arc\/STAMP weighting options, and with 2, 4, and 6 STAMPs. All plans were created with automated skin flash. RAD plans were compared to conventional RapidArc (RA) plans. The DVH metrics and MUs for each plan were recorded, and a paired T\u2010test was used to test for statistically significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0\u2264\u00a00.05) differences between the plans.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\u201cOptimize between static angles\u201d was the best option for dynamic collimator setting. Increasing the number of STAMPs from 2 to 4 or 6 lowered PTV V105% in patients where the PTV V105% was high but provided limited benefit in most patients. Selecting arc\u2010dominant weighting yields significantly worse DVH metrics than a balanced weighting. Dosimetric differences were minimal between (0) Balanced, (1) Static, or (2) Static\u2010Dominant weighting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The following are recommended as a starting point for breast and chest wall RAD plans: 2 STAMPs positioned similar to breast tangents, \u201coptimize between static angles\u201d for the dynamic collimator, and a weighting of either (0) balanced, (1) static, or (2) static\u2010dominant. The arc\u2010dominant setting resulted in plans of the lowest quality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70442","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T07:44:22Z","timestamp":1770623062000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Optimizing breast and chest wall treatment planning: Integrating dynamic collimator rotation with static\u2010angle modulated ports in VMAT radiotherapy"],"prefix":"10.1002","volume":"27","author":[{"given":"Emily","family":"Hubley","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Koger","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taoran","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Department of Medical Affairs Varian Medical Systems  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Risolo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Salerno","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan M.","family":"Scheuermann","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boon\u2010Keng Kevin","family":"Teo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61629-2"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60488-8"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20160701"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.05.038"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/02841860802657227"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2015.05.003"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/15330338221143937"},{"issue":"6","key":"e_1_2_9_9_1","article-title":"Comparison of advanced dynamic arc therapy with collimator rotation and fixed integrated gantry positions to the standard of care across five treatment sites","volume":"17","author":"Clark R","year":"2025","journal-title":"Cureus"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.70036"},{"key":"e_1_2_9_11_1","article-title":"Performance evaluation of a new automated skin flash method for radiotherapy of breast cancer","volume":"35","author":"Nyk\u00e4nen T","year":"2025","journal-title":"Phi RO"},{"key":"e_1_2_9_12_1","article-title":"Rotational arc treatments with static ports and dynamic collimation reduced cardiopulmonary dose for esophageal cancer patients and diminishes model\u2010based predicted benefit of proton therapy","volume":"36","author":"Populaire P","year":"2025","journal-title":"Phi RO"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3598442"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2019.05.010"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70442","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acm2.70442","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70442","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:42:44Z","timestamp":1791985364000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.70442"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/acm2.70442"],"URL":"https:\/\/doi.org\/10.1002\/acm2.70442","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70442"}}