Article
Oncology
Margot Bleeker, Jorrit Visser, Karin Goudschaal, Arjan Bel, Maarten C. C. M. Hulshof, Jan-Jakob Sonke, Astrid van der Horst
Summary: This study evaluates the dosimetric benefit of a library of plans (LoP) compared to the traditional single-plan (SP) strategy for pre-operative gastric radiotherapy. The results show that the LoP strategy reduces the average planning target volume (PTV) and decreases the dose to organs-at-risk (OARs), potentially reducing radiation-induced toxicities.
RADIOTHERAPY AND ONCOLOGY
(2023)
Article
Oncology
Dominique Reijtenbagh, Jeremy Godart, Joan Penninkhof, Sandra Quint, Andras Zolnay, Jan-Willem Mens, Mischa Hoogeman
Summary: This study compared the performance of the current PotD strategy with non-adaptive and fully online-adaptive techniques in the treatment of cervical cancer patients. The findings show that the PotD protocol is effective in improving normal tissue sparing compared to no adaptation, while fully online-adaptive approaches can further reduce target volume but come with a more complex workflow.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Yoon Young Jo, Ji Woon Yea, Jaehyeon Park, Se An Oh, Jae Won Park
Summary: Bladder filling variation presents a challenge for radiotherapy delivery. Adaptive radiotherapy using individualized plan libraries has shown good survival outcomes and high local control rates.
Article
Oncology
Michelle Oud, Sebastiaan Breedveld, Marta Gizynska, Michiel Kroesen, Stefan Hutschemaekers, Steven Habraken, Steven Petit, Zoltan Perko, Ben Heijmen, Mischa Hoogeman
Summary: This study proposes and evaluates a new approach in intensity modulated proton therapy, which involves the daily selection of plans from patient-specific pre-treatment established plan libraries for treatment. Compared to daily online re-planning, this approach is simpler and reduces the risk of xerostomia and dysphagia, while improving adherence to target coverage constraints.
RADIOTHERAPY AND ONCOLOGY
(2022)
Article
Oncology
Robert Huddart, Shaista Hafeez, Rebecca Lewis, Helen McNair, Isabelle Syndikus, Ann Henry, John Staffurth, Monisha Dewan, Catalina Vassallo-Bonner, Syed Ali Moinuddin, Alison Birtle, Gail Horan, Yvonne Rimmer, Ramachandran Venkitaraman, Vincent Khoo, Anita Mitra, Simon Hughes, Stephanie Gibbs, Gaurav Kapur, Angela Baker, Vibeke Nordmark Hansen, Emma Patel, Emma Hall
Summary: The HYBRID trial evaluated hypofractionated radiation therapy for muscle-invasive bladder cancer patients, demonstrating that adaptive planning can minimize normal tissue irradiation and improve outcomes. The study showed that the adaptive radiation therapy is safe and effective for this patient population.
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
(2021)
Article
Oncology
Kathryn E. Mittauer, Sreenija Yarlagadda, John M. Bryant, Nema Bassiri, Tino Romaguera, Andres G. Gomez, Robert Herrera, Rupesh Kotecha, Minesh P. Mehta, Alonso N. Gutierrez, Michael Chuong
Summary: This study describes a 5-fraction ablative SMART planning approach for pancreatic cancer that is robust and stable during on-table adaption, due to gradients controlled by a GI PRV technique and the use of rings. These findings are noteworthy given that daily interfraction anatomic GI OAR differences are routine, thus necessitating on-table adaptation. This work supports feasibility towards utilizing a patient-independent, template on-table adaptive approach.
RADIOTHERAPY AND ONCOLOGY
(2023)
Article
Oncology
Yajun Song, Yun Zhang, Huadong Wang, Mengyu Zhao, Fada Guan, Zhenjiang Li, Jinbo Yue
Summary: The stomach is a highly deformable organ, making it challenging to treat gastric cancer with conventional image-guided radiotherapy. However, magnetic resonance imaging guided radiotherapy (MRgRT) using MR-LINAC offers a feasible solution for adaptive treatment of deformable organs such as the stomach, leading to promising results.
FRONTIERS IN ONCOLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Laura Masi, Victor Hernandez, Jordi Saez, Raffaela Doro, Lorenzo Livi
Summary: The utility of complexity metrics for CyberKnife (CK) MLC plans was assessed in this study, adapting and computing complexity indices defined for IMRT plans. Relationships between plan complexity, optimization algorithms, and patient-specific quality assurance (PSQA) results were studied. Strong and very strong correlations were found between some pairs of complexity metrics.
Article
Radiology, Nuclear Medicine & Medical Imaging
Yvonne J. M. de Hond, Paul. M. A. van Haaren, An-Sofie E. Verrijssen, Rob H. N. Tijssen, Coen W. Hurkmans
Summary: This study investigated the impact of new techniques to improve CBCT image quality and plan selection consistency on the accuracy of LoP selection in cervical cancer patients. The use of synthetic CTs (sCTs) was found to increase agreement among observers in plan selection and lead to more frequent selection of the gold standard.
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS
(2023)
Article
Oncology
Tomohiko Matsuyama, Yoshiyuki Fukugawa, Junichiro Kuroda, Ryo Toya, Takahiro Watakabe, Tadashi Matsumoto, Natsuo Oya
Summary: Adaptive radiotherapy for glioblastoma improved target coverage and reduced dose to normal brain tissue. Analysis based on resection rate showed a decrease in normal brain tissue dose for patients with gross total resection, and an increase in coverage for those with partial resection or biopsy.
RADIATION ONCOLOGY
(2022)
Article
Oncology
Arthur Galand, Jessica Prunaretty, Nicolas Mir, Aurelie Morel, Celine Bourgier, Norbert Ailleres, David Azria, Pascal Fenoglietto
Summary: The study evaluated the feasibility of online adaptive radiotherapy with Ethos for breast cancer, showing high accuracy of AI segmentation and superiority of adapted plans in target volume coverage, but medical assessment is still required.
FRONTIERS IN ONCOLOGY
(2023)
Article
Oncology
Femke Vaassen, Colien Hazelaar, Richard Canters, Stephanie Peeters, Steven Petit, Wouter van Elmpt
Summary: This study evaluated the dosimetric differences between treatment plans optimized using various organ-at-risk (OAR) contouring methods. The results showed that dose differences arising from automatic contour variations were of a similar magnitude or lower than those from intra-observer contour variability. Recommendations include correcting delineation errors when the heart overlaps with the PTV for Heart D-mean and checking contours if they are close to the PTV for D-max parameters.
RADIOTHERAPY AND ONCOLOGY
(2021)
Article
Oncology
Maria Cristina Leonardi, Matteo Pepa, Rosa Luraschi, Sabrina Vigorito, Samantha Dicuonzo, Lars Johannes Isaksson, Maria Rosa La Porta, Lorenza Marino, Edy Ippolito, Alessandra Huscher, Angela Argenone, Fiorenza De Rose, Francesca Cucciarelli, Maria Carmen De Santis, Francesca Rossi, Agnese Prisco, Roberta Guarnaccia, Paola Tabarelli de Fatis, Isabella Palumbo, Sarah Pia Colangione, Maria Mormile, Vincenzo Ravo, Alessandra Fozza, Cynthia Aristei, Roberto Orecchia, Federica Cattani, Barbara Alicja Jereczek-Fossa, Cristina Leonardi, Matteo Pepa, Simone Giovanni Gugliandolo, Rosa Luraschi, Sabrina Vigorito, Anna Morra, Samantha Dicuonzo, Marianna Alessandra Gerardi, Lars Johannes Isaksson, Maria Alessia Zerella, Maria Rosa La Porta, Domenico Cante, Edoardo Petrucci, Lorenza Marino, Giuseppina Borzi, Edy Ippolito, Maristella Marrocco, Alessandra Huscher, Matteo Chieregato, Angela Argenone, Luciano Iadanza, Fiorenza De Rose, Francesca Lobefalo, Francesca Cucciarelli, Marco Valenti, Maria Carmen De Santis, Anna Cavallo, Francesca Rossi, Serenella Russo, Agnese Prisco, Marika Guernieri, Roberta Guarnaccia, Tiziana Malatesta, Ilaria Meaglia, Marco Liotta, Paola Tabarelli de Fatis, Isabella Palumbo, Marta Marcantonini, Sarah Pia Colangione, Emilio Mezzenga, Sara Falivene, Maria Mormile, Vincenzo Ravo, Cecilia Arrichiello, Alessandra Fozza, Maria Paola Barbero, Giovanni Battista Ivaldi, Gianpiero Catalano, Cristiana Vidali, Cynthia Aristei, Caterina Giannittb, Delia Ciardo, Antonella Ciabattoni, Icro Meattini, Roberto Orecchia, Federica Cattani, Barbara Alicja Jereczek-Fossa
Summary: This study quantitatively assessed the impact of contouring variability of axillary lymph nodes on the dose distribution in locoregional radiotherapy for breast cancer. The results showed that the coverage of the reference volumes was suboptimal, especially for level L4. Intensity-modulated radiotherapy was widely used, but the contouring issues could not be compensated by the CTV-to-PTV margins. These findings highlight the need for delineation training and standardization.
RADIOTHERAPY AND ONCOLOGY
(2022)
Article
Oncology
Mihaly Simon, Judit Papp, Emese Csiki, Arpad Kovacs
Summary: The study evaluated the FSRT treatment technique used in the department based on various plan quality indices, showing that the approach can achieve clinically acceptable treatment plans for a wide spectrum of PTV volumes.
FRONTIERS IN ONCOLOGY
(2022)
Review
Oncology
Adham Hijab, Boris Tocco, Ian Hanson, Hanneke Meijer, Christina Junker Nyborg, Anders Smedegaard Bertelsen, Robert Jan Smeenk, Gillian Smith, Jeff Michalski, Brian C. Baumann, Shaista Hafeez
Summary: Radiotherapy plays a significant role in both curative and palliative treatment of bladder cancer, but faces technical challenges such as poor tumor visualization and bladder size variability. Magnetic resonance imaging (MRI) is favored for tumor visualization and staging, and the integration of MRI scanning with linear accelerator in MR-Linac systems allows for real-time plan adaptation during treatment, potentially improving outcomes for bladder cancer patients. However, robust evidence is needed to determine if MR-guided radiotherapy translates into better patient outcomes before widespread clinical implementation.
FRONTIERS IN ONCOLOGY
(2021)
Article
Engineering, Biomedical
Benjamin K. F. Lau, Tess Reynolds, Paul J. Keall, Jan-Jakob Sonke, Shalini K. Vinod, Owen Dillon, Ricky T. O'Brien
Summary: This study investigates the dose and time limits of adaptive 4DCBCT acquisitions compared with current conventional 4DCBCT acquisition. The results show that adaptive-acquisition with lower imaging dose and faster scan time can achieve equivalent or improved image quality compared to conventional-acquisition.
PHYSICS IN MEDICINE AND BIOLOGY
(2022)
Article
Engineering, Biomedical
Chris Beekman, Eva Schaake, Jan-Jakob Sonke, Peter Remeijer
Summary: A neural network for fast prediction of cervical cancer radiotherapy planning CTV deformations was proposed and validated using finite element modeling data. Results showed that the predicted CTV libraries had high Dice scores (>0.95) and low surface distances (<3 mm) compared to the FEM libraries. Clinical evaluation demonstrated improved performance of the predicted libraries over the current method used in clinic.
PHYSICS IN MEDICINE AND BIOLOGY
(2021)
Article
Oncology
Margot Bleeker, Maarten C. C. M. Hulshof, Arjan Bel, Jan-Jakob Sonke, Astrid van der Horst
Summary: In order to create a library of plans for gastric cancer adaptive radiotherapy, accurate predictions of stomach shape changes due to filling variations are crucial. This study compared personalized and population-based strategies for predicting stomach shape based on filling, and found that the population-based model outperformed the personalized model, demonstrating its potential for use in a gastric cancer treatment plan library.
RADIOTHERAPY AND ONCOLOGY
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Lukas Schroder, Uros Stankovic, Simon Rit, Jan-Jakob Sonke
Summary: Improvement of image quality in cone beam computed tomography scans can be achieved through dual energy imaging and iterative reconstruction, particularly in image quality phantoms.
BIOMEDICAL PHYSICS & ENGINEERING EXPRESS
(2022)
Review
Oncology
Karin M. Meijer, Irma W. E. M. van Dijk, Sophie C. Huijskens, Joost G. Daams, Brian V. Balgobind, Arjan Bel
Summary: This systematic review investigates organ motion, margin sizes, and delineation variability in pediatric radiation therapy. The study found heterogeneity regarding age, tumor types, anesthesia usage, and imaging modalities, resulting in wide variation in organ motion and delineation variability. The results suggest the potential for reducing margin sizes in children, but the existing differences hinder the use of standardized margins.
RADIOTHERAPY AND ONCOLOGY
(2022)
Article
Engineering, Biomedical
Erik van der Bijl, Peter Remeijer, Jan-Jakob Sonke, Uulke A. van der Heide, Tomas Janssen
Summary: This study introduces a method to update treatment margins based on patient treatment history and explores the potential benefits of adaptive margins. The results show that using adaptive margins can reduce margins in most patients without compromising those with greater than average target motion.
PHYSICS IN MEDICINE AND BIOLOGY
(2022)
Article
Engineering, Biomedical
Carlos Huesa-Berral, Celia Juan-Cruz, Simon van Kranen, Maddalena Rossi, Jose Belderbos, Juan Diego Azcona, Javier Burguete, Jan-Jakob Sonke
Summary: This study evaluates and validates the dosimetric effect of respiratory motion and inter-fraction variations in SBRT using 4D-CT and daily 4D-CBCT dose accumulation scenarios. The results show that both 4D-Acc and 3D-Acc have an impact on the dose, especially in the tumor and organs at risk region. The effectiveness of CT-CBCT deformable image registration techniques is also validated.
PHYSICS IN MEDICINE AND BIOLOGY
(2023)
Article
Oncology
Hania Al-Hallaq, Richard Castillo, Astrid van der Horst, Curtiland Deville, David J. Carlson
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
(2023)
Article
Oncology
Margot Bleeker, Jorrit Visser, Karin Goudschaal, Arjan Bel, Maarten C. C. M. Hulshof, Jan-Jakob Sonke, Astrid van der Horst
Summary: This study evaluates the dosimetric benefit of a library of plans (LoP) compared to the traditional single-plan (SP) strategy for pre-operative gastric radiotherapy. The results show that the LoP strategy reduces the average planning target volume (PTV) and decreases the dose to organs-at-risk (OARs), potentially reducing radiation-induced toxicities.
RADIOTHERAPY AND ONCOLOGY
(2023)
Article
Gastroenterology & Hepatology
Margot Bleeker, Astrid van der Horst, Arjan Bel, Jan-Jakob Sonke, Jeanin E. van Hooft, R. E. Pouw, Maarten C. C. M. Hulshof
Summary: This study assessed the technical feasibility and potential benefits of endoscopically placing fiducial markers in gastric cancer patients for image-guided radiotherapy. The results showed that marker placement was technically feasible and safe, with markers being well visible and positionally stable, providing a potential benefit for image-guided radiotherapy.
ENDOSCOPY INTERNATIONAL OPEN
(2023)
Meeting Abstract
Oncology
M. Bleeker, R. Pouw, A. Bel, J. Sonke, M. Hulshof, A. van der Horst
RADIOTHERAPY AND ONCOLOGY
(2022)
Article
Oncology
Derek A. Mumaw, Allison J. Hazy, Aleksander Vayntraub, Thomas J. Quinn, Kamran Salari, John H. Chang, Noah Kalman, Sanford Katz, James Urbanic, Robert H. Press, Arpi Thukral, Henry Tsai, George E. Laramore, Jason Molitoris, Carlos Vargas, Samir H. Patel, Craig Stevens, Rohan L. Deraniyagala
Summary: This study evaluated contralateral recurrences in patients with oropharyngeal squamous cell carcinoma who received unilateral proton beam therapy. The results showed a favorable contralateral neck failure rate that was comparable to photon irradiation.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Kangpyo Kim, Dongryul Oh, Jae Myoung Noh, Yang Won Min, Hong Kwan Kim, Yong Chan Ahn
Summary: This study suggests that hypofractionated radiation therapy alone is a feasible option for early stage esophageal squamous cell carcinoma patients. Particularly, in patients with tumor length < 3 cm, this treatment scheme shows favorable local control rates with low incidence of esophageal toxicities.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Lin Chen, Jing Li, Kunpeng Li, Jiang Hu, Qingjie Li, Chenglong Huang, Gaoyuan Wang, Na Liu, Linglong Tang
Summary: This study analyzed the probability of hearing impairment after radiotherapy for nasopharyngeal carcinoma and developed a predictive model, providing dose limitation suggestions to improve patients' quality of life.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Yiwei Yang, Jianxin Wang, Feng Gao, Zhen Liu, Tangzhi Dai, Haowen Zhang, Hongyu Zhu, Tingting Wang, Dexin Xiao, Kui Zhou, Zheng Zhou, Dai Wu, Xiaobo Du, Sen Bai
Summary: This paper provides a comprehensive description of the current status of PARTER, which is the first experimental FLASH platform utilizing megavoltage X-rays. It showcases the reliable performance and stability of the dosimeters and monitors used in PARTER, as well as the satisfactory dose distribution and characteristics of the FLASH X-rays. The platform effectively meets the requirements of preclinical research on megavoltage X-ray FLASH and undergoes continuous upgrades.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Maria Thor, Kelly Fitzgerald, Aditya Apte, Jung Hun Oh, Aditi Iyer, Otasowie Odiase, Saad Nadeem, Ellen D. Yorke, Jamie Chaft, Abraham J. Wu, Michael Offin, Charles B. Simone Ii, Isabel Preeshagul, Daphna Y. Gelblum, Daniel Gomez, Joseph O. Deasy, Andreas Rimner
Summary: The purpose of this study was to identify predictors of disease progression in early-stage non-small cell lung cancer (NSCLC) patients after receiving definitive stereotactic body radiation therapy (SBRT). The results showed that tumor diameter and SUVmax were the most frequently reported features associated with progression/survival, and a re-fitted model including these two features had the best performance.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Yong-Qiao He, Tong-Min Wang, Da-Wei Yang, Wen-Qiong Xue, Chang-Mi Deng, Dan-Hua Li, Wen-Li Zhang, Ying Liao, Ruo-Wen Xiao, Lu-Ting Luo, Hua Diao, Xia-Ting Tong, Yan-Xia Wu, Xue-Yin Chen, Jiang-Bo Zhang, Ting Zhou, Xi-Zhao Li, Pei-Fen Zhang, Xiao-Hui Zheng, Shao-Dan Zhang, Ye-Zhu Hu, Guan-Qun Zhou, Jun Ma, Ying Sun, Wei-Hua Jia
Summary: In this study, researchers aimed to establish a predictive model for radiation-induced brain injury (RBI) in nasopharyngeal carcinoma (NPC) patients by incorporating clinical factors and newly developed genetic variants. They conducted a large-scale retrospective study and a genome-wide association study to develop a polygenic risk score (PRS) for RBI risk prediction. The results showed that the PRS, combined with clinical factors, improved the accuracy of RBI risk stratification and suggested personalized radiotherapy.
RADIOTHERAPY AND ONCOLOGY
(2024)
Review
Oncology
Xiaoyong Xiang, Zhe Ji, Jing Jin
Summary: A review of studies suggests that brachytherapy as a salvage therapy for recurrent glioblastoma shows acceptable safety and good post-treatment clinical efficacy for selected patients.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
M. Berbee, C. T. Muijs, F. E. M. Voncken, L. Wee, M. Sosef, B. van Etten, J. W. van Sandick, F. A. R. M. Warmerdam, J. J. de Haan, E. Oldehinkel, J. M. van Dieren, L. Boersma, J. A. Langendijk, A. van der Schaaf, J. B. Reitsma, E. Schuit
Summary: This study externally validated a model for predicting 2-year total mortality in lung cancer patients in esophageal cancer patients. The intercept and/or slope of the original model needed adjustment to achieve good performance in esophageal cancer patients.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Dominique Reijtenbagh, Jeremy Godart, Joan Penninkhof, Sandra Quint, Andras Zolnay, Jan-Willem Mens, Mischa Hoogeman
Summary: This study compared the performance of the current PotD strategy with non-adaptive and fully online-adaptive techniques in the treatment of cervical cancer patients. The findings show that the PotD protocol is effective in improving normal tissue sparing compared to no adaptation, while fully online-adaptive approaches can further reduce target volume but come with a more complex workflow.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Albrecht Weiss, Steffen Loeck, Ting Xu, Zhongxing Liao, Aswin L. Hoffmann, Esther G. C. Troost
Summary: Traditional models for predicting radiation pneumonitis may not be applicable to non-small cell lung cancer patients treated with passively-scattered proton therapy. The use of effective alpha/beta parameter can predict the occurrence of radiation pneumonitis in these patients.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Z. A. R. Gouw, J. Jeong, A. Rimner, N. Y. Lee, A. Jackson, A. Fu, J-j. Sonke, J. O. Deasy
Summary: This study investigates the effectiveness of non-uniform fractionation schedules in radiotherapy for early-stage non-small cell lung cancer. Through modeling, optimized schedules are proposed to minimize local failures and toxicity risk. The results suggest that non-standard primer shot fractionation can reduce hypoxia-induced radioresistance and improve treatment outcomes.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Sara Ronchi, Alessandro Cicchetti, Maria Bonora, Rossana Ingargiola, Anna Maria Camarda, Stefania Russo, Sara Imparato, Paolo Castelnuovo, Ernesto Pasquini, Piero Nicolai, Mohssen Ansarin, Michele Del Vecchio, Marco Benazzo, Ester Orlandi, Barbara Vischioni
Summary: This study evaluates the efficacy and toxicity of carbon ion radiotherapy (CIRT) in locally advanced head and neck mucosal melanoma patients. The results show that CIRT is safe and effective in treating the local region, and immunotherapy after relapse can improve overall survival. However, further prospective trials are needed to assess the role of targeted/immune- systemic therapy in this disease.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Dominik Wawrzuta, Justyna Klejdysz, Marzanna Chojnacka
Summary: This study analyzed articles about radiation oncology published in The New York Times since its inception in 1851, and identified changes in media sentiment and prevalent themes related to radiotherapy. The findings suggest an increasing negative sentiment in media coverage towards radiotherapy, with a shift towards reporting treatment errors, toxicity, and ineffectiveness.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Elaine Limkin, Pierre Blanchard, Benjamin Lacas, Jean Bourhis, Mahesh Parmar, Lisa Licitra, Quynh-Thu Le, Sue S. Yom, Catherine Fortpied, Johannes Langendijk, Jan B. Vermorken, Jacques Bernier, Jens Overgaard, Jonathan Harris, Jean-Pierre Pignon, Anne Auperin
Summary: This study investigated the impact of season of radiotherapy on the outcomes of head and neck squamous cell cancer patients. The results showed that the season of radiotherapy did not have any significant effect on patient outcomes.
RADIOTHERAPY AND ONCOLOGY
(2024)
Article
Oncology
Fabio L. Cury, Gustavo A. Viani, Andre G. Gouveia, Camila V. S. Freire, Gabriel de A. Grisi, Fabio Y. Moraes
Summary: In limb-sparing treatment of soft tissue sarcoma patients, a 5-day course of preoperative radiotherapy results in high local control and favorable R0 margins, with acceptable complication rates, particularly for patients receiving higher biological equivalent doses.
RADIOTHERAPY AND ONCOLOGY
(2024)