{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:45:23Z","timestamp":1791362723192,"version":"4.3.1"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T00:00:00Z","timestamp":1731542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To assess the dosimetric effectiveness of image-guided radiation treatment (IGRT) and online adaptive radiation therapy (oART) for cervical cancer. As well as survival follow-up was conducted to validated the safety and efficacy of oART.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 15 cervical cancer patients were enrolled. oART was performed on a CT-integrated linear accelerator. The initial plan was revised to include the distribution of IGRT dose using daily fan-beam CT (FBCT) images, after which the distinctions between ART and IGRT in terms of target coverage and organs at risk (OARs) sparing were analyzed. Survival follow-up was conducted to validated the safety and efficacy of oART in this group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PTV Dmax value decreased by 1.23 Gy in the ART plan when compared to that in the IGRT plan; PTV D95 increased by 1.34 Gy; PTV V50 coverage increased by 4.86%; CTV coverage increased by 3.02%; PTV D2cc of the colon, rectum, and small intestine decreased by 1.24 Gy, 1.29 Gy, and 1.12 Gy, respectively. The V10 and V30 of the pelvis increased by 1.27% and 0.56%, respectively, while the V30 of the left and right femoral heads dropped by 2.82% and 3.41%, respectively. Except for the pelvic changes, all other differences were statistically significant (p &amp;lt; 0.01). The average time for the ART procedure was 21.22\u00a0min (range: 18.72\u201324.90 min). The median follow-up time is 28.0 months. Median event-free survival and overall survival were not reached. EFS rate and OS rate at 3 years were 79.4% and 92.9%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Online ART for cervical cancer can minimize the dose of OARs and enhance the target volume coverage significantly when compared to IGRT with satisfied survival time.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2024.1399468","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T06:21:10Z","timestamp":1731565270000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["First implementation and results of online adaptive radiotherapy for cervical cancer based on CT-Linac 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