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Journal of Oncology
Volume 2010, Article ID 407236, 12 pages
Research Article

On-Line Adaptive Radiation Therapy: Feasibility and Clinical Study

1Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA
2Department of Radiation Oncology, The Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA

Received 11 May 2010; Revised 9 August 2010; Accepted 25 September 2010

Academic Editor: Lei Xing

Copyright © 2010 Taoran Li et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The purpose of this paper is to evaluate the feasibility and clinical dosimetric benefit of an on-line, that is, with the patient in the treatment position, Adaptive Radiation Therapy (ART) system for prostate cancer treatment based on daily cone-beam CT imaging and fast volumetric reoptimization of treatment plans. A fast intensity-modulated radiotherapy (IMRT) plan reoptimization algorithm is implemented and evaluated with clinical cases. The quality of these adapted plans is compared to the corresponding new plans generated by an experienced planner using a commercial treatment planning system and also evaluated by an in-house developed tool estimating achievable dose-volume histograms (DVHs) based on a database of existing treatment plans. In addition, a clinical implementation scheme for ART is designed and evaluated using clinical cases for its dosimetric qualities and efficiency.