{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:07:43Z","timestamp":1787504863276,"version":"build-2736575974"},"reference-count":28,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T00:00:00Z","timestamp":1650499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>A dosimetric study was performed to show the importance of adaptive radiotherapy (ART) for head and neck cancer (HNC) patients using volumetric modulated arc therapy (VMAT). A total of 13 patients with HNC who required replanning during radiotherapy were included in this study. All plans succeeded to achieve the set objectives regarding target volume coverage and organ sparing. All target volumes presented a significant decrease with an average of 76.44 cm3 (p = 0.007) for PTVlow risk, 102.81 cm3 (p = 0.021) for PTVintermediate risk, and 47.10 cm3 (p = 0.003) for PTVhigh risk. Additionally, a positive correlation was found between PTV shrinkage and the number of fractions completed before replanning. Significant volume decrease was also observed for the parotid glands. The ipsilateral parotid decreased in volume by a mean of 3.75 cm3 (14.43%) (p = 0.067), while the contralateral decreased by 4.23 cm3 (13.23%) (p = 0.033). For all analyzed organs, a reduction in the final dose received after replanning was found. Our study showed that ART via rescanning, recontouring, and replanning using VMAT is essential whenever anatomical and positional variations occur. Furthermore, comparison with the literature has confirmed that ART using VMAT offers similar results to ART with intensity modulated radiotherapy.<\/jats:p>","DOI":"10.3390\/jpm12050668","type":"journal-article","created":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T21:39:45Z","timestamp":1650749985000},"page":"668","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Adaptive Radiotherapy in Head and Neck Cancer Using Volumetric Modulated Arc Therapy"],"prefix":"10.3390","volume":"12","author":[{"given":"Nikolett","family":"Buciuman","sequence":"first","affiliation":[{"name":"Faculty of Physics, West University of Timisoara, 300223 Timisoara, Romania"},{"name":"OncoHelp Foundation, 300239 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6703-979X","authenticated-orcid":false,"given":"Loredana G.","family":"Marcu","sequence":"additional","affiliation":[{"name":"Faculty of Physics, West University of Timisoara, 300223 Timisoara, Romania"},{"name":"Faculty of Informatics & Science, University of Oradea, 410087 Oradea, Romania"},{"name":"Cancer Research Institute, University of South Australia, Adelaide, SA 5001, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5175","DOI":"10.1002\/cam4.4079","article-title":"A Study to Assess the Dosimetric Impact of the Anatomical Changes Occurring in the Parotid Glands and Tumour Volume during Intensity Modulated Radiotherapy using Simultaneous Integrated Boost (IMRT-SIB) in Head and Neck Squamous Cell Cancers","volume":"10","author":"Ghosh","year":"2021","journal-title":"Cancer Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e375","DOI":"10.1016\/j.ijrobp.2011.07.004","article-title":"Monitoring dosimetric impact of weight loss with kilovoltage (KV) cone beam CT (CBCT) during parotid-sparing IMRT and concurrent chemotherapy","volume":"82","author":"Ho","year":"2012","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"164","DOI":"10.4103\/0971-6203.139005","article-title":"Impact of repeat computerized tomography replans in the radiation therapy of head and neck cancers","volume":"39","author":"Bhandari","year":"2014","journal-title":"J. Med. Phys."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"533","DOI":"10.4103\/jcrt.JCRT_594_17","article-title":"Adaptive intensity-modulated radiotherapy in head-and-neck cancer: A volumetric and dosimetric study","volume":"15","author":"Burela","year":"2019","journal-title":"J. Cancer Res. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1016\/j.ijrobp.2009.04.005","article-title":"Weekly volume and dosimetric changes during chemoradiotherapy with intensity-modulated radiation therapy for head and neck cancer: A prospective observational study","volume":"6","author":"Bhide","year":"2010","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1016\/j.ijrobp.2008.04.013","article-title":"Assessment of parotid gland dose changes during head and neck cancer radiotherapy using daily megavoltage computed tomography and deformable image registration","volume":"71","author":"Lee","year":"2008","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s13014-015-0331-x","article-title":"Parotid gland shrinkage during IMRT predicts the time to Xerostomia resolution","volume":"10","author":"Sanguineti","year":"2015","journal-title":"Radiat. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Beyzadeoglu, M., Ozyigit, G., and Selek, U. (2015). Radiation Therapy for Head and Neck Cancers: A Case-Based Review, Springer International Publishing.","DOI":"10.1007\/978-3-319-10413-3"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1080\/0284186X.2018.1505053","article-title":"Adaptive radiotherapy for head and neck cancer","volume":"57","author":"Castelli","year":"2018","journal-title":"Acta Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.1002\/hed.23532","article-title":"Long-term experience with reduced planning target volume margins and intensity-modulated radiotherapy with daily image-guidance for head and neck cancer","volume":"36","author":"Chen","year":"2014","journal-title":"Head Neck"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.meddos.2019.05.003","article-title":"An evaluation of adaptive planning by assessing the dosimetric impact of weight loss throughout the course of radiotherapy in bilateral treatment of head and neck cancer patients","volume":"45","author":"Stauch","year":"2020","journal-title":"Med. Dosim."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.meddos.2016.01.001","article-title":"Relative plan robustness of step-and-shoot vs rotational intensity\u2013modulated radiotherapy on repeat computed tomographic simulation for weight loss in head and neck cancer","volume":"41","author":"Thomson","year":"2016","journal-title":"Med. Dosim."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1016\/j.ijrobp.2003.12.024","article-title":"Quantification of volumetric and geometric changes occurring during fractionated radiotherapy for head-and-neck cancer using an integrated CT\/linear accelerator system","volume":"59","author":"Barker","year":"2004","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1016\/j.ijrobp.2010.10.072","article-title":"A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer","volume":"82","author":"Jensen","year":"2012","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/j.ijrobp.2005.07.957","article-title":"Repeat CT imaging and replanning during the course of IMRT for head-and-neck cancer","volume":"64","author":"Hansen","year":"2006","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.radonc.2010.10.009","article-title":"The role of replanning in fractionated intensity modulated radiotherapy for nasopharyngeal carcinoma","volume":"98","author":"Zhao","year":"2011","journal-title":"Radiother. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s13014-014-0318-z","article-title":"Impact of head and neck cancer adaptive radiotherapy to spare the parotid glands and decrease the risk of xerostomia","volume":"10","author":"Castelli","year":"2015","journal-title":"Radiat. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/j.ijrobp.2007.01.030","article-title":"Spatial and dosimetric variability of organs at risk in head-and-neck intensity-modulated radiotherapy","volume":"68","author":"Robar","year":"2007","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"van Timmeren, J.E., Chamberlain, M., Bogowicz, M., Ehrbar, S., Dal Bello, R., Sch\u00fcler, H.G., Krayenbuehl, J., Wilke, L., Andratschke, N., and Guckenberger, M. (2021). MR-Guided Adaptive Radiotherapy for Head and Neck Cancer: Prospective Evaluation of Migration and Anatomical Changes of the Major Salivary Glands. Cancers, 13.","DOI":"10.3390\/cancers13215404"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.semradonc.2009.11.002","article-title":"Adaptive radiotherapy of head and neck cancer","volume":"20","author":"Castadot","year":"2010","journal-title":"Semin. Radiat. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1016\/j.ijrobp.2007.10.063","article-title":"Local anatomic changes in parotid and submandibular glands during radiotherapy for oropharynx cancer and correlation with dose, studied in detail with nonrigid registration","volume":"70","author":"Hoogeman","year":"2008","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/acm2.12587","article-title":"Three discipline collaborative radiation therapy special debate: All head and neck cancer patients with intact tumors\/nodes should have scheduled adaptive replanning performed at least once during the course of radiotherapy","volume":"20","author":"Soisson","year":"2019","journal-title":"J. Appl. Clin. Med. Phys."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1016\/j.ijrobp.2011.08.017","article-title":"Adaptive radiotherapy for head-and-neck cancer: Initial clinical outcomes from a prospective trial","volume":"83","author":"Schwartz","year":"2011","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"600","DOI":"10.4103\/jcrt.JCRT_928_19","article-title":"Clinical and dosimetric impact of adaptive intensity-modulated radiotherapy in locally advanced head-and-neck cancer","volume":"16","author":"Maheshwari","year":"2020","journal-title":"J. Cancer Res. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4010","DOI":"10.1002\/mp.13697","article-title":"Texture-based, automatic contour validation for online adaptive replanning: A feasibility study on abdominal organs","volume":"46","author":"Zhang","year":"2019","journal-title":"Med. Phys."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.oraloncology.2018.08.010","article-title":"Adaptive radiotherapy for head and neck cancer: Are we ready to put it into routine clinical practice?","volume":"86","author":"Gensheimer","year":"2018","journal-title":"Oral Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"6942","DOI":"10.4081\/rt.2017.6942","article-title":"Helical Tomotherapy\u00ae is a Safe and Feasible Technique for Total Scalp Irradiation","volume":"9","author":"Cuccia","year":"2017","journal-title":"Rare Tumors"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1080\/0284186X.2020.1821090","article-title":"Daily dosimetric variation between image-guided volumetric modulated arc radiotherapy and MR-guided daily adaptive radio-therapy for prostate cancer stereotactic body radiotherapy","volume":"60","author":"Nicosia","year":"2021","journal-title":"Acta Oncol."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/5\/668\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:58:11Z","timestamp":1760137091000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/12\/5\/668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,21]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["jpm12050668"],"URL":"https:\/\/doi.org\/10.3390\/jpm12050668","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,21]]}}}