{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:40:49Z","timestamp":1792402849471,"version":"4.4.0"},"reference-count":50,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dose\u2010guided adaptive fractionation (DGAF) was proposed as a simpler alternative of adaptive radiation therapy, using organ variation simulation for proof of concept. However, its dosimetric benefit using actual daily anatomy changes in prostate cancer patients remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The purpose of this study was to retrospectively evaluate the dosimetric benefit and potential risk of DGAF for prostate cancer patients treated with moderately hypofractionated radiotherapy and stereotactic body radiotherapy using daily cone\u2010beam CT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients assessed in this study were treated with moderately hypofractionated radiotherapy (MHRT,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a011, 244 total fractions) and stereotactic body radiotherapy (SBRT,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a011, 55 total fractions). The optimizer algorithm computed the desired fractional dose based on favorable or unfavorable anatomical conditions derived from daily imaging, quantified by the sparing factor threshold (\u03bc) and spread (\u03c3). Three methods of estimating subsequent fractionation schemes were explored. The assessment relative to patient\u2010specific probabilities observed post\u2010treatment includes the cohort\u2010based probability (CBP) approach, the individual\u2010based probability (IBP) approach, and the hybrid approach that begins as CBP and transitions to the IBP after a certain number of fractions. The benefits\/risks of DGAF were assessed by calculating the equivalent dose in 2\u00a0Gy fractions (EQD2) for both the CTV and the rectum in comparison to regular fractionation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>DGAF demonstrated potential dosimetric benefits for intact prostate patients. The average and standard deviation of the sparing factor was 0.51\u00a0\u00b1\u00a00.11 for MHRT patients and 0.42\u00a0\u00b1\u00a00.04 for SBRT patients treated with endorectal\u2010balloon. The hybrid approach for estimating the patients\u2019 threshold \u03bc and spread \u03c3 outperformed other approaches assessed for both cohorts. The highest dosimetric benefit was retrospectively seen in MHRT patients where a hybrid approach were used, showing equal or decreased D15% EQD2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DGAF demonstrated considerable rectum sparing potential, and the benefits increased with longer fractionation and advanced approaches toward subsequent fraction estimation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70865","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:20:41Z","timestamp":1792038041000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of online dose\u2010guided adaptive fractionation for intact prostate radiotherapy"],"prefix":"10.1002","volume":"27","author":[{"given":"Gevork S.","family":"Gevorkyan","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Libing","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic Arizona  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3739-3272","authenticated-orcid":false,"given":"Riley C.","family":"Tegtmeier","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of South Florida Morsani College of Medicine  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Santos Toesca","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic Arizona  Phoenix Arizona 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