{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:09:20Z","timestamp":1793329760061,"version":"4.5.0"},"reference-count":33,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007210","name":"Varian Medical Systems","doi-asserted-by":"publisher","award":["NCT03892720"],"award-info":[{"award-number":["NCT03892720"]}],"id":[{"id":"10.13039\/100007210","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>This study evaluates the potential for tumor dose escalation in recurrent head and neck cancer (rHNC) patients with automated non-coplanar volumetric modulated arc therapy (VMAT) stereotactic body radiation therapy (SBRT) planning (HyperArc). Twenty rHNC patients are planned with conventional VMAT SBRT to 40 Gy while minimizing organ-at-risk (OAR) doses. They are then re-planned with the HyperArc technique to match these minimal OAR doses while escalating the target dose as high as possible. Then, we compare the dosimetry, tumor control probability (TCP), and normal tissue complication probability (NTCP) for the two plan types. Our results show that the HyperArc technique significantly increases the mean planning target volume (PTV) and gross tumor volume (GTV) doses by 10.8 \u00b1 4.4 Gy (25%) and 11.5 \u00b1 5.1 Gy (26%) on average, respectively. There are no clinically significant differences in OAR doses, with maximum dose differences of &lt;2 Gy on average. The average TCP is 23% (\u00b1 21%) higher for HyperArc than conventional plans, with no significant differences in NTCP for the brainstem, cord, mandible, or larynx. HyperArc can achieve significant tumor dose escalation while maintaining minimal OAR doses in the head and neck\u2014potentially enabling improved local control for rHNC SBRT patients without increased risk of treatment-related toxicities.<\/jats:p>","DOI":"10.3390\/cancers13081910","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T12:11:00Z","timestamp":1618488660000},"page":"1910","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Automated Non-Coplanar VMAT for Dose Escalation in Recurrent Head and Neck Cancer Patients"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6189-0313","authenticated-orcid":false,"given":"Kaley","family":"Woods","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert K.","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiri A.","family":"Cook","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Oregon Health &amp; Science University, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Sheng","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar U.","family":"Kishan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John V.","family":"Hegde","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Tenn","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minsong","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1093\/annonc\/mdh308","article-title":"Patterns of failure, prognostic factors and survival in locoregionally advanced head and neck cancer treated with concomitant chemoradiotherapy: A 9-year, 337-patient, multi-institutional experience","volume":"15","author":"Brockstein","year":"2004","journal-title":"Ann. 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