{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T21:39:28Z","timestamp":1791409168122,"version":"4.3.3"},"reference-count":39,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Dieter Morszeck Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Purpose: The Ethos (Varian Medical Systems) radiotherapy device combines semi-automated anatomy detection and plan generation for cone beam computer tomography (CBCT)-based daily online adaptive radiotherapy (oART). However, CBCT offers less soft tissue contrast than magnetic resonance imaging (MRI). This work aims to present the clinical workflow of CBCT-based oART with shuttle-based offline MR guidance. Methods: From February to November 2023, 31 patients underwent radiotherapy on the Ethos (Varian, Palo Alto, CA, USA) system with machine learning (ML)-supported daily oART. Moreover, patients received weekly MRI in treatment position, which was utilized for daily plan adaptation, via a shuttle-based system. Initial and adapted treatment plans were generated using the Ethos treatment planning system. Patient clinical data, fractional session times (MRI + shuttle transport + positioning, adaptation, QA, RT delivery) and plan selection were assessed for all fractions in all patients. Results: In total, 737 oART fractions were applied and 118 MRIs for offline MR guidance were acquired. Primary sites of tumors were prostate (n = 16), lung (n = 7), cervix (n = 5), bladder (n = 1) and endometrium (n = 2). The treatment was completed in all patients. The median MRI acquisition time including shuttle transport and positioning to initiation of the Ethos adaptive session was 53.6 min (IQR 46.5\u201363.4). The median total treatment time without MRI was 30.7 min (IQR 24.7\u201339.2). Separately, median adaptation, plan QA and RT times were 24.3 min (IQR 18.6\u201332.2), 0.4 min (IQR 0.3\u20131,0) and 5.3 min (IQR 4.5\u20136.7), respectively. The adapted plan was chosen over the scheduled plan in 97.7% of cases. Conclusion: This study describes the first workflow to date of a CBCT-based oART combined with a shuttle-based offline approach for MR guidance. The oART duration times reported resemble the range shown by previous publications for first clinical experiences with the Ethos system.<\/jats:p>","DOI":"10.3390\/cancers16061210","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T05:04:12Z","timestamp":1710911052000},"page":"1210","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Clinical Workflow of Cone Beam Computer Tomography-Based Daily Online Adaptive Radiotherapy with Offline Magnetic Resonance Guidance: The Modular Adaptive Radiotherapy System (MARS)"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0775-8565","authenticated-orcid":false,"given":"Ji-Young","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bouchra","family":"Tawk","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Translational Radiation Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital (UKHD) and German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9037-3980","authenticated-orcid":false,"given":"Maximilian","family":"Knoll","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Translational Radiation Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital (UKHD) and German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"German Cancer Consortium (DKTK), Core Center Heidelberg, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Hoegen-Sa\u00dfmannshausen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Liermann","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Huber","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Molecular Radiooncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Lifferth","sequence":"additional","affiliation":[{"name":"Division of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clemens","family":"Lang","sequence":"additional","affiliation":[{"name":"Division of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"H\u00e4ring","sequence":"additional","affiliation":[{"name":"Division of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regula","family":"Gnirs","sequence":"additional","affiliation":[{"name":"Division of Radiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6056-9747","authenticated-orcid":false,"given":"Oliver","family":"J\u00e4kel","sequence":"additional","affiliation":[{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"},{"name":"Division of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz-Peter","family":"Schlemmer","sequence":"additional","affiliation":[{"name":"Division of Radiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Debus","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"},{"name":"Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"H\u00f6rner-Rieber","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1731-7090","authenticated-orcid":false,"given":"Fabian","family":"Weykamp","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"},{"name":"Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany"},{"name":"Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany"},{"name":"National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1088\/0031-9155\/42\/1\/008","article-title":"Adaptive radiation therapy","volume":"42","author":"Yan","year":"1997","journal-title":"Phys. Med. Biol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.semradonc.2019.02.007","article-title":"Adaptive Radiotherapy for Anatomical Changes","volume":"29","author":"Sonke","year":"2019","journal-title":"Semin. Radiat. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e41","DOI":"10.1016\/j.ijrobp.2023.06.739","article-title":"Daily Adaptive vs. Non-Adaptive External Beam Radiation Therapy with Concurrent Chemotherapy for Locally Advanced Non-Small Cell Lung Cancer (NSCLC): A Prospective Randomized Trial of an Individualized Approach for Toxicity Reduction (ARTIA-Lung)","volume":"117","author":"Stanley","year":"2023","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1016\/j.ijrobp.2009.10.013","article-title":"Online adaptive replanning method for prostate radiotherapy","volume":"77","author":"Ahunbay","year":"2010","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s13014-023-02394-2","article-title":"Evaluation of PTV margins with daily iterative online adaptive radiotherapy for postoperative treatment of endometrial and cervical cancer: A prospective single-arm phase 2 study","volume":"19","author":"Wang","year":"2024","journal-title":"Radiat. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1093\/jrr\/rrs041","article-title":"Interfractional and intrafractional errors assessed by daily cone-beam computed tomography in nasopharyngeal carcinoma treated with intensity-modulated radiation therapy: A prospective study","volume":"53","author":"Lu","year":"2012","journal-title":"J. Radiat. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.radonc.2016.08.019","article-title":"Adaptive radiotherapy for advanced lung cancer ensures target coverage and decreases lung dose","volume":"121","author":"Moller","year":"2016","journal-title":"Radiother. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.ijrobp.2016.07.011","article-title":"Head and Neck Margin Reduction with Adaptive Radiation Therapy: Robustness of Treatment Plans against Anatomy Changes","volume":"96","author":"Wolf","year":"2016","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1741","DOI":"10.3389\/fonc.2020.01741","article-title":"Problems and Promises of Introducing the Magnetic Resonance Imaging Linear Accelerator Into Routine Care: The Case of Prostate Cancer","volume":"10","author":"Hehakaya","year":"2020","journal-title":"Front. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"34","DOI":"10.3322\/caac.21707","article-title":"Magnetic resonance linear accelerator technology and adaptive radiation therapy: An overview for clinicians","volume":"72","author":"Hall","year":"2022","journal-title":"CA Cancer J. Clin."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1016\/j.ijrobp.2017.04.023","article-title":"Online Adaptive Radiation Therapy","volume":"99","author":"Keller","year":"2017","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Paganetti, H., Botas, P., Sharp, G.C., and Winey, B. (2021). Adaptive proton therapy. Phys. Med. Biol., 66.","DOI":"10.1088\/1361-6560\/ac344f"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e13539","DOI":"10.1002\/acm2.13539","article-title":"Assessment of efficacy in automated plan generation for Varian Ethos intelligent optimization engine","volume":"23","author":"Pokharel","year":"2022","journal-title":"J. Appl. Clin. Med. Phys."},{"key":"ref_14","unstructured":"Varian (2019). Ethos Algorithm Reference Guide, Varian. Publication ID: P1035867-002-B."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e13961","DOI":"10.1002\/acm2.13961","article-title":"A roadmap for implementation of kV-CBCT online adaptive radiation therapy and initial first year experiences","volume":"24","author":"Stanley","year":"2023","journal-title":"J. Appl. Clin. Med. Phys."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.phro.2020.12.004","article-title":"Clinical implementation of artificial intelligence-driven cone-beam computed tomography-guided online adaptive radiotherapy in the pelvic region","volume":"17","author":"Sibolt","year":"2021","journal-title":"Phys. Imaging Radiat. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1080\/0284186X.2023.2257377","article-title":"Clinical experiences with online adaptive radiotherapy of vulvar carcinoma","volume":"62","author":"Bak","year":"2023","journal-title":"Acta Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e13479","DOI":"10.1002\/acm2.13479","article-title":"Varian ethos online adaptive radiotherapy for prostate cancer: Early results of contouring accuracy, treatment plan quality, and treatment time","volume":"23","author":"Byrne","year":"2022","journal-title":"J. Appl. Clin. Med. Phys."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.radonc.2022.03.014","article-title":"Online adaptive radiotherapy of urinary bladder cancer with full re-optimization to the anatomy of the day: Initial experience and dosimetric benefits","volume":"171","author":"Astrom","year":"2022","journal-title":"Radiother. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/1748-717X-9-12","article-title":"MR-guidance\u2014A clinical study to evaluate a shuttle- based MR-linac connection to provide MR-guided radiotherapy","volume":"9","author":"Bostel","year":"2014","journal-title":"Radiat. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s00066-017-1258-y","article-title":"Prospective feasibility analysis of a novel off-line approach for MR-guided radiotherapy","volume":"194","author":"Bostel","year":"2018","journal-title":"Strahlenther. Onkol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1056\/NEJMoa1408648","article-title":"Results of a trial of PET-directed therapy for early-stage Hodgkin\u2019s lymphoma","volume":"372","author":"Radford","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/S1470-2045(20)30013-9","article-title":"Imaging-based target volume reduction in chemoradiotherapy for locally advanced non-small-cell lung cancer (PET-Plan): A multicentre, open-label, randomised, controlled trial","volume":"21","author":"Nestle","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.ejro.2015.11.003","article-title":"Role of 3T multiparametric-MRI with BOLD hypoxia imaging for diagnosis and post therapy response evaluation of postoperative recurrent cervical cancers","volume":"3","author":"Mahajan","year":"2016","journal-title":"Eur. J. Radiol. Open"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2174","DOI":"10.1016\/j.ejrad.2016.10.011","article-title":"Can Diffusion-weighted Magnetic Resonance Imaging Predict Survival in Patients with Cervical Cancer? A Meta-Analysis","volume":"85","author":"Wang","year":"2016","journal-title":"Eur. J. Radiol."},{"key":"ref_26","first-page":"615643","article-title":"Quantitative Magnetic Resonance Imaging for Biological Image-Guided Adaptive Radiotherapy","volume":"10","author":"Yang","year":"2020","journal-title":"Front. Oncol."},{"key":"ref_27","first-page":"77","article-title":"Making on-line adaptive radiotherapy possible using artificial intelligence and machine learning for efficient daily re-planning","volume":"8","author":"Archambault","year":"2020","journal-title":"Med. Phys. Int. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e13876","DOI":"10.1002\/acm2.13876","article-title":"Do we need patient-specific QA for adaptively generated plans? Retrospective evaluation of delivered online adaptive treatment plans on Varian Ethos","volume":"24","author":"Zhao","year":"2023","journal-title":"J. Appl. Clin. Med. Phys."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/j.ijrobp.2023.10.009","article-title":"Pelvic Irradiation for Node-Positive Prostate Cancer After Prostatectomy: Long-Term Results of the Prospective PLATIN-4 and PLATIN-5 Trials","volume":"118","author":"Fink","year":"2024","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1007\/s10147-022-02124-w","article-title":"Intensity-modulated radiation therapy for prostate cancer after rectal surgery: A single hospital long-term safety analysis","volume":"27","author":"Zhang","year":"2022","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.semradonc.2014.02.012","article-title":"A facility for magnetic resonance-guided radiation therapy","volume":"24","author":"Jaffray","year":"2014","journal-title":"Semin. Radiat. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/1748-717X-4-54","article-title":"Systematisation of spatial uncertainties for comparison between a MR and a CT-based radiotherapy workflow for prostate treatments","volume":"4","author":"Nyholm","year":"2009","journal-title":"Radiat. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"107175","DOI":"10.1016\/j.lungcan.2023.03.011","article-title":"To fly or not to fly: Stereotactic MR-guided adaptive radiotherapy effectively treats ultracentral lung tumors with favorable long-term outcomes","volume":"179","author":"Regnery","year":"2023","journal-title":"Lung Cancer"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Weykamp, F., Hoegen, P., Regnery, S., Katsigiannopulos, E., Renkamp, C.K., Lang, K., Konig, L., Sandrini, E., Meixner, E., and Rippke, C. (2023). Long-Term Clinical Results of MR-Guided Stereotactic Body Radiotherapy of Liver Metastases. Cancers, 15.","DOI":"10.3390\/cancers15102786"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1093\/jnci\/djaa184","article-title":"Precision Radiotherapy: Reduction in Radiation for Oropharyngeal Cancer in the 30 ROC Trial","volume":"113","author":"Riaz","year":"2021","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"6303","DOI":"10.3390\/curroncol29090495","article-title":"Changes in Apparent Diffusion Coefficient (ADC) in Serial Weekly MRI during Radiotherapy in Patients with Head and Neck Cancer: Results from the PREDICT-HN Study","volume":"29","author":"Ng","year":"2022","journal-title":"Curr. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"897130","DOI":"10.3389\/fonc.2022.897130","article-title":"Longitudinal Correlations Between Intravoxel Incoherent Motion (IVIM) and Dynamic Contrast-Enhanced (DCE) MRI During Radiotherapy in Prostate Cancer Patients","volume":"12","author":"Kooreman","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.semradonc.2009.11.003","article-title":"Adaptive radiotherapy for lung cancer","volume":"20","author":"Sonke","year":"2010","journal-title":"Semin. Radiat. Oncol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Weykamp, F., Meixner, E., Arians, N., Hoegen-Sassmannshausen, P., Kim, J.Y., Tawk, B., Knoll, M., Huber, P., Konig, L., and Sander, A. (2024). Daily AI-Based Treatment Adaptation under Weekly Offline MR Guidance in Chemoradiotherapy for Cervical Cancer 1: The AIM-C1 Trial. J. Clin. Med., 13.","DOI":"10.3390\/jcm13040957"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/6\/1210\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:16:16Z","timestamp":1760105776000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/6\/1210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,19]]},"references-count":39,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["cancers16061210"],"URL":"https:\/\/doi.org\/10.3390\/cancers16061210","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,19]]}}}