{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T03:27:28Z","timestamp":1768793248799,"version":"3.49.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Radiat Oncol"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>To investigate the feasibility and benefits of a modified adaptive radiotherapy (ART) by replanning in the initial CT (iCT) with new contours from a repeat CT (rCT) based on CT-CT image fusion for nasopharyngeal cancer (NPC) patients underwent volumetric modulated arc radiotherapy (VMAT).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>Nine NPC patients underwent VMAT treatment with a rCT at 23rd fraction were enrolled in this study. Dosimetric differences for replanning VMAT plans in the iCT and in the rCT were compared. Volumetric and dosimetric changes of gross tumor volume (GTV) and organs at risk (OARs) of this modified ART were also investigated.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>No dosimetric differences between replanning in the iCT and in the rCT were observed. The average volume of GTV decreased from 78.83\u2009\u00b1\u200938.42\u00a0cm<jats:sup>3<\/jats:sup> in the iCT to 71.44\u2009\u00b1\u200937.46\u00a0cm<jats:sup>3<\/jats:sup> in the rCT, but with no significant difference (p\u2009=\u20090.42).The average volume of the left and right parotid decreased from 19.91\u2009\u00b1\u20094.89\u00a0cm<jats:sup>3<\/jats:sup> and 21.58\u2009\u00b1\u20096.16\u00a0cm<jats:sup>3<\/jats:sup> in the iCT to 11.80\u2009\u00b1\u20092.79\u00a0cm<jats:sup>3<\/jats:sup> and 13.29\u2009\u00b1\u20094.17\u00a0cm<jats:sup>3<\/jats:sup> in the rCT (both p\u2009&lt;\u20090.01), respectively. The volume of other OARs did not shrink very much. No significant differences on PTV<jats:sub>GTV<\/jats:sub> and PTV<jats:sub>CTV<\/jats:sub> coverage were observed for replanning with this modified ART. Compared to the initial plans, the average mean dose of the left and right parotid after re-optimization were decreased by 62.5\u00a0cGy (p\u2009=\u20090.05) and 67.3\u00a0cGy (p\u2009=\u20090.02), respectively, and the V5 (the volume receiving 5\u00a0Gy) of the left and right parotids were decreased by 7.8% (p\u2009=\u20090.01) and 11.2% (p\u2009=\u20090.001), respectively. There was no significant difference on the dose delivered to other OARs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Patients with NPC undergoing VMAT have significant anatomic and dosimetric changes to parotids. Repeat CT as an anatomic changes reference and re-optimization in the iCT based on CT-CT image fusion was accurate enough to identify the volume changes and to ensure safe dose to parotids.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1748-717x-8-277","type":"journal-article","created":{"date-parts":[[2013,11,27]],"date-time":"2013-11-27T02:03:11Z","timestamp":1385517791000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["A modified VMAT adaptive radiotherapy for nasopharyngeal cancer patients based on CT-CT image fusion"],"prefix":"10.1186","volume":"8","author":[{"given":"Xiance","family":"Jin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ce","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongqiang","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinling","family":"Yi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huawei","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Congying","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2013,11,27]]},"reference":[{"key":"995_CR1","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/S0360-3016(03)00075-0","volume":"56","author":"MK Kam","year":"2003","unstructured":"Kam MK, Chau RM, Suen J, Choi PH, Teo PM: Intensity-modulated radiotherapy in nasopharyngeal carcinoma: dosimetric advantage over conventional plans and feasibility of dose escalation. Int J Radiat Oncol Biol Phys 2003, 56: 145-157. 10.1016\/S0360-3016(03)00075-0","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"995_CR2","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/j.clon.2011.06.006","volume":"24","author":"TF Lee","year":"2012","unstructured":"Lee TF, Ting HM, Chao PJ, Fang FM: Dual arc volumetric-modulated arc radiotherapy (VMAT) of nasopharyngeal carcinomas: a simultaneous integrated boost treatment plan comparison with intensity-modulated radiotherapies and single arc VMAT. Clin Oncol 2012, 24: 196-207. 10.1016\/j.clon.2011.06.006","journal-title":"Clin Oncol"},{"key":"995_CR3","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/S1470-2045(10)70290-4","volume":"12","author":"CM Nutting","year":"2011","unstructured":"Nutting CM, Morden JP, Harrington KJ, Urbano TG, Bhide SA, Clark C, Miles EA, Miah AB, Newbold K, Tanay M, Adab F, Jefferies SJ, Scrase C, Yap BK, A\u2019Hern RP, Sydenham MA, Emson M, Hall E: PARSPORT trial management group: parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol 2011, 12: 127-136. 10.1016\/S1470-2045(10)70290-4","journal-title":"Lancet Oncol"},{"key":"995_CR4","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1016\/j.ijrobp.2007.10.067","volume":"70","author":"CH Han","year":"2008","unstructured":"Han CH, Chen YJ, Liu AL, Schultheiss TE, Wong JY: Actual dose variation of parotid glands and spinal cord for nasopharyngeal cancer patients during radiotherapy. Int J Radiat Oncol Biol Phys 2008, 70: 1256-1262. 10.1016\/j.ijrobp.2007.10.067","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"995_CR5","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/s11912-012-0221-4","volume":"14","author":"DL Schwartz","year":"2012","unstructured":"Schwartz DL: Current progress in adaptive radiation therapy for head and neck cancer. Curr Oncol Rep 2012, 14: 139-147. 10.1007\/s11912-012-0221-4","journal-title":"Curr Oncol Rep"},{"key":"995_CR6","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1016\/j.ijrobp.2005.07.957","volume":"64","author":"EK Hansen","year":"2006","unstructured":"Hansen EK, Bucci MK, Quivey JM, Weinberg V, Xia P: Repeated CT imaging and replanning during the course of IMRT for head-and-neck cancer. Int J Radiat Oncol Biol Phys 2006, 64: 355-362. 10.1016\/j.ijrobp.2005.07.957","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"995_CR7","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1016\/j.ijrobp.2009.08.036","volume":"77","author":"W Wang","year":"2010","unstructured":"Wang W, Yang H, Hu W, Shan G, Ding W, Yu C, Wang B, Wang X, Xu Q: Clinical study of the necessity of replanning before the 25th fraction during the course of intensity-modulated radiotherapy for patients with nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 2010, 77: 617-621. 10.1016\/j.ijrobp.2009.08.036","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"995_CR8","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.radonc.2010.10.009","volume":"98","author":"L Zhao","year":"2011","unstructured":"Zhao L, Wan Q, Zhou Y, Deng X, Xie C, Wu S: The role of replanning in fractioned intensity modulated radiotherapy for nasopharyngeal carcinoma. Radioth and Oncol 2011, 98: 23-27. 10.1016\/j.radonc.2010.10.009","journal-title":"Radioth and Oncol"},{"key":"995_CR9","doi-asserted-by":"publisher","first-page":"1360","DOI":"10.1016\/j.ijrobp.2009.04.005","volume":"76","author":"SA Bhide","year":"2010","unstructured":"Bhide SA, Davies M, Burke K, McNair HA, Hansen V, Barbachano Y, El-Hariry IA, Newbold K, Harrington KJ, Nutting CM: Weekly volume and dosimetric changes during chemoradiotherapy with intensity-modulated radiation therapy for head and neck cancer: a prospective observational study. Int J Radiat Oncol Biol Phys 2010, 76: 1360-1368. 10.1016\/j.ijrobp.2009.04.005","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"995_CR10","doi-asserted-by":"publisher","first-page":"S160","DOI":"10.1016\/S0360-3016(04)01135-6","volume":"60","author":"R Steenbakkers","year":"2004","unstructured":"Steenbakkers R, Duppen J, Fitton I, Deurloo K, Zijp L, Eisbruch A, Nowak P, Van Herk M, Rasch C: Observer variation in delineation of nasopharyngeal carcinoma for radiotherapy: a 3-D analysis. Int J Radiat Oncol Biol Phys 2004, 60: S160-S161.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"995_CR11","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.meddos.2011.01.006","volume":"37","author":"WWK Fung","year":"2012","unstructured":"Fung WWK, Wu VWC: Teo PML: Dosimetric evaluation of a three-phase adaptive radiotherapy for nasopharyngeal carcinoma using helical tomotherapy. Med Dosim 2012, 37: 92-97. 10.1016\/j.meddos.2011.01.006","journal-title":"Med Dosim"},{"key":"995_CR12","doi-asserted-by":"publisher","first-page":"s40","DOI":"10.1016\/j.ijrobp.2005.12.041","volume":"66","author":"SX Wu","year":"2006","unstructured":"Wu SX, Xie CY, Jin XC, Zhang P: Simultaneous modulated accelerated radiation therapy in the treatment of nasopharyngeal cancer: a local center\u2019s experience. Int J Radiat Oncol Biol Phys 2006, 66: s40-s46.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"995_CR13","volume-title":"Comparison of whole field simultaneous integrated boost VMAT and IMRT in the treatment of nasopharyngeal cancer, Medical Dosimetry","author":"X Jin","year":"2013","unstructured":"Jin X, Yi J, Zhou Y, Yan H, Han C, Xie C: Comparison of whole field simultaneous integrated boost VMAT and IMRT in the treatment of nasopharyngeal cancer, Medical Dosimetry. 2013.http:\/\/dx.doi.org\/10.1016\/j.meddos.2013.05.004"},{"key":"995_CR14","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1016\/j.ijrobp.2003.12.024","volume":"59","author":"JL Barker","year":"2004","unstructured":"Barker JL, Garden AS, Ang KK, O\u2019Daniel JC, Wang H, Court LE, Morrison WH, Rosenthal DI, Chao KS, Tucker SL, Mohan R, Dong L: Quantification of volumetric and geometric changes occurring during fractionated radiotherapy for head-and-neck cancer using an integrated CT\/linear accelerator system. Int J Radiat Oncol Biol Phys 2004, 59: 960-970. 10.1016\/j.ijrobp.2003.12.024","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"995_CR15","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.ijrobp.2010.01.071","volume":"81","author":"F Ricchetti","year":"2011","unstructured":"Ricchetti F, Wu B, McNutt T, Wong J, Forastiere A, Marur S, Starmer H, Sanguineti G: Volume change of selected organs at risk during IMRT for oropharyngeal cancer. Int J Radiat Oncol Biol Phys 2011, 81: 161-168.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"995_CR16","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.radonc.2008.07.006","volume":"89","author":"C Lee","year":"2008","unstructured":"Lee C, Langen KM, Lu W, Haimerl J, Schnarr E, Ruchala KJ, Olivera GH, Meeks SL, Kupelian PA, Shellenberger TD, Ma\u00f1on RR: Evaluation of geometric changes of parotid glands during head and neck cancer radiotherapy using daily MVCT and automatic deformable registration. Radiother Oncol 2008, 89: 81-88. 10.1016\/j.radonc.2008.07.006","journal-title":"Radiother Oncol"},{"key":"995_CR17","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/j.ijrobp.2007.10.063","volume":"70","author":"EM Vasquez Osorio","year":"2008","unstructured":"Vasquez Osorio EM, Hoogeman MS, Al-Mamgani A, Tequh DN, Levendag PC, Heijmen BJ: Local anatomic changes in parotid and submandibular glands during radiotherapy for oropharynx cancer and correlation with dose, studied in detail with nonrigid registration. Int J Radiat Oncol Biol Phys 2008, 70: 875-882. 10.1016\/j.ijrobp.2007.10.063","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"995_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2011\/690595","volume":"2011","author":"DL Schwartz","year":"2011","unstructured":"Schwartz DL, Dong L: Adaptive radiation therapy for head and neck cancer-can an old goal evolve into a new standard? J Oncol 2011, 2011: 1-14.","journal-title":"J Oncol"}],"container-title":["Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1748-717X-8-277.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T02:23:38Z","timestamp":1630549418000},"score":1,"resource":{"primary":{"URL":"https:\/\/ro-journal.biomedcentral.com\/articles\/10.1186\/1748-717X-8-277"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,11,27]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["995"],"URL":"https:\/\/doi.org\/10.1186\/1748-717x-8-277","relation":{},"ISSN":["1748-717X"],"issn-type":[{"value":"1748-717X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,11,27]]},"assertion":[{"value":"18 June 2013","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 November 2013","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 November 2013","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"277"}}