Solution for the hot spots in adaptive radiotherapy planning for cervical cancer: a case report and review of literature.

Authors

Peng Jiang, Xiang Wang, Shubao Cui, Chengyu Ren, Zilu Wang, Yongchun Zhang, Xiaoqian Wu

Published in

Frontiers in oncology. Volume 16. Pages 1862463. Epub Jun 26, 2026.

Abstract

The Ethos system (version 2.0, Varian Medical Systems, Palo Alto, CA) is an online adaptive radiotherapy (ART) platform that can automatically replan based on the daily anatomical structure and achieve precise dose delivery. However, the highly automated online ART workflow may sometimes lead to excessive dose accumulation within the target in adaptive plan. This article reports a cervical cancer case in which hot spots appeared in the adaptive plan during adaptive treatment session. In these adaptive plans with hot spots, the edge of target was close to the multi-leaf collimator (MLC) boundary, resulting in limited leaf movement and reduced modulation flexibility. Therefore, we propose an improved online ART workflow to correct the deviation of the target, which effectively reduced the risk of hot spots in adaptive plan. This article discusses the problem occurrence, clinical response strategies and improved ART workflow, aiming to provide reference for improving the quality of adaptive plan and safety and stability of ART.

PMID:
42434736
Bibliographic data and abstract were imported from PubMed on 11 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.