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Introduction A novel on-line adaptive radiotherapy (ART) system based on O-ring linear accelerator (LINAC) and cone-beam CT (CBCT) was evaluated for treatment and management of head 82% ≥4), though mandible was rated lower than others (p 0.05). In addition, a general decrease in accumulated OAR dose was observed with adaptation. Unsupervised adapted plans where contours were auto-generated without human review still spared OAR at a greater rate than the original plans, suggesting benefits of adaptation can be maintained even with some leniency in contour accuracy. Conclusion Feasibility of a novel, semi-automated on-line ART system for various head and neck (H&N) cancer sites was demonstrated in terms of treatment duration, dosimetric benefits, and automated contour accuracy in a remote emulator environment. Adaptive planning duration was clinically viable at 19 min and 34 sec, but further improvements in automated contour accuracy and performance improvements of plan auto-generation may reduce adaptive planning duration by up to 10 minutes.
Yoon et al. (Tue,) studied this question.