Action Levels on Dose and Anatomic Variation for Adaptive Radiation Therapy Using Daily Offline Plan Evaluation: Preliminary Results Baoshe Zhang, PhD,

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Action Levels on Dose and Anatomic Variation for Adaptive Radiation Therapy Using Daily Offline Plan Evaluation: Preliminary Results Baoshe Zhang, PhD, Sung-Woo Lee, PhD, Shifeng Chen, PhD, Jinghao Zhou, PhD, Karl Prado, PhD, Warren D'Souza, PhD, Byongyong Yi, PhD Practical Radiation Oncology Volume 9, Issue 1, Pages 49-54 (January 2019) DOI: 10.1016/j.prro.2018.08.006 Copyright © 2018 American Society for Radiation Oncology Terms and Conditions

Figure 1 System diagram of our clinical implementation: cone beam computed tomography–collecting module, plan registration module, dose calculation module, evaluation and action module. Practical Radiation Oncology 2019 9, 49-54DOI: (10.1016/j.prro.2018.08.006) Copyright © 2018 American Society for Radiation Oncology Terms and Conditions

Figure 2 Maximum value of dose-volume histogram variations among D95, D90, D10, and D5 versus image correlation coefficient in 20 patients (5 with prostate cancer [◆], 5 with lung cancer [●], and 10 with head and neck cancer [▲]) at the time that replanning was requested clinically. Solid green symbols represent patients who did not need replanning; orange striped symbols represent patients whose predicted replanning was earlier than the actual clinical replanning; and purple checked symbols represent patients whose predicted replanning agreed with actual clinical replanning. (A color version of this figure is available at https://doi.org/10.1016/j.prro.2018.08.006.) Practical Radiation Oncology 2019 9, 49-54DOI: (10.1016/j.prro.2018.08.006) Copyright © 2018 American Society for Radiation Oncology Terms and Conditions

Figure 3 Temporal variation of indices of a patient with head and neck cancer. Solid line = PCC; dotted lines = dose-volume histogram variation of cone beam computed tomography planning target volume doses (D95, D90, D10, and D5) of the n-th fraction versus those of the first fraction. Practical Radiation Oncology 2019 9, 49-54DOI: (10.1016/j.prro.2018.08.006) Copyright © 2018 American Society for Radiation Oncology Terms and Conditions

Figure 4 Temporal variation of indices of a lung patient. Solid line = Pearson's correlation coefficient; dotted lines = dose-volume histogram variation of cone beam computed tomography planning target volume doses (D95, D90, D10, and D5) of the n-th fraction versus those of the first fraction. Practical Radiation Oncology 2019 9, 49-54DOI: (10.1016/j.prro.2018.08.006) Copyright © 2018 American Society for Radiation Oncology Terms and Conditions