{"doi":"10.1093/jnci/djaf232","title":"Impact of daily adaptive head and neck radiotherapy on toxicity and quality of life: results of the DARTBOARD phase II randomized trial","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:sec>\n                    <jats:title>Background</jats:title>\n                    <jats:p>The utility of adaptive radiotherapy (ART) for head and neck squamous cell carcinoma (HNSCC) remains poorly defined. Daily ART (DART) promises both anatomic adaptation and planning target volume (PTV) reduction. In this prospective trial using cone-beam computed tomography-based ART, patients with HNSCC undergoing definitive radiotherapy (RT) or chemoradiotherapy (CRT) were randomly assigned to DART with reduced PTV margins or no ART with standard margins (image-guided RT [IGRT]).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>Eligibility criteria included a diagnosis of oropharynx, larynx, or hypopharynx HNSCC receiving definitive radiotherapy. All individuals received involved nodal radiotherapy per previous institutional study. The PTV margins were 1 mm (2 mm craniocaudal) vs 5 mm in the DART and IGRT arms, respectively. The primary endpoint was patient-reported xerostomia at 1 year, assessed with the Xerostomia Questionnaire (XQ).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>Fifty patients were enrolled (26 IGRT, 24 DART) between March 2022 and June 2023. The cohort consisted of 38 oropharynx and 12 larynx/hypopharynx patients. The mean ipsilateral parotid gland, ipsilateral and contralateral submandibular gland doses were significantly lower with DART. There was significantly less acute dermatitis in the DART arm (Grade 0/1/2 0%/69%/31% vs 17%/75%/8% DART, P = .01) but no significant difference in any patient-reported outcome at 1 year. The adjusted difference in XQ score at 1 year was 10.0 (95% CI = −4.7 to 24.7, P = .58).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion</jats:title>\n                    <jats:p>Online DART for HNSCC is oncologically sound and improved acute toxicity profiles, but it did not reduce patient-reported xerostomia, the primary endpoint. Additional evidence is needed to understand the potential benefits and limitations of this paradigm, including its cost-effectiveness.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration</jats:title>\n                    <jats:p>clinicaltrials.gov identifier, NCT04883281</jats:p>\n                  </jats:sec>","journal":"JNCI: Journal of the National Cancer Institute","year":2025,"id":609752,"datarank":0.31191623125197543,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.0,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":932215,"name":"Vladimir Avkshtol","orcid":"0000-0003-2644-813X","position":1,"is_corresponding":false},{"id":283110,"name":"Mu‐Han Lin","orcid":"0000-0002-7992-5465","position":2,"is_corresponding":false},{"id":360534,"name":"Jing Wang","orcid":"0000-0002-8491-4146","position":3,"is_corresponding":false},{"id":280742,"name":"Liyuan Chen","orcid":"0000-0002-5345-0086","position":4,"is_corresponding":false},{"id":1567372,"name":"Chien-Yi Liao","orcid":"0009-0007-0872-327X","position":5,"is_corresponding":false},{"id":1279793,"name":"Randall Hughes","orcid":"0000-0002-8246-0611","position":6,"is_corresponding":false},{"id":763653,"name":"Sean Domal","orcid":"0000-0002-5988-5240","position":7,"is_corresponding":false},{"id":329848,"name":"Chul Ahn","orcid":"0000-0002-2997-9203","position":8,"is_corresponding":false},{"id":767977,"name":"Dominic H. Moon","orcid":"0000-0001-9161-7783","position":9,"is_corresponding":false},{"id":473868,"name":"David J. Sher","orcid":"0000-0003-3943-7480","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Impact of daily adaptive head and neck radiotherapy on toxicity and quality of life: results of the DARTBOARD phase II randomized trial","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:sec>\n                    <jats:title>Background</jats:title>\n                    <jats:p>The utility of adaptive radiotherapy (ART) for head and neck squamous cell carcinoma (HNSCC) remains poorly defined. Daily ART (DART) promises both anatomic adaptation and planning target volume (PTV) reduction. In this prospective trial using cone-beam computed tomography-based ART, patients with HNSCC undergoing definitive radiotherapy (RT) or chemoradiotherapy (CRT) were randomly assigned to DART with reduced PTV margins or no ART with standard margins (image-guided RT [IGRT]).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods</jats:title>\n                    <jats:p>Eligibility criteria included a diagnosis of oropharynx, larynx, or hypopharynx HNSCC receiving definitive radiotherapy. All individuals received involved nodal radiotherapy per previous institutional study. The PTV margins were 1 mm (2 mm craniocaudal) vs 5 mm in the DART and IGRT arms, respectively. The primary endpoint was patient-reported xerostomia at 1 year, assessed with the Xerostomia Questionnaire (XQ).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Results</jats:title>\n                    <jats:p>Fifty patients were enrolled (26 IGRT, 24 DART) between March 2022 and June 2023. The cohort consisted of 38 oropharynx and 12 larynx/hypopharynx patients. The mean ipsilateral parotid gland, ipsilateral and contralateral submandibular gland doses were significantly lower with DART. There was significantly less acute dermatitis in the DART arm (Grade 0/1/2 0%/69%/31% vs 17%/75%/8% DART, P = .01) but no significant difference in any patient-reported outcome at 1 year. The adjusted difference in XQ score at 1 year was 10.0 (95% CI = −4.7 to 24.7, P = .58).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion</jats:title>\n                    <jats:p>Online DART for HNSCC is oncologically sound and improved acute toxicity profiles, but it did not reduce patient-reported xerostomia, the primary endpoint. Additional evidence is needed to understand the potential benefits and limitations of this paradigm, including its cost-effectiveness.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration</jats:title>\n                    <jats:p>clinicaltrials.gov identifier, NCT04883281</jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":1.9459101490553132,"endowment":1.9459101490553132,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"40833933","pmcid":null,"openalex_id":"https://openalex.org/W4413372959","authors":[],"funders":[{"funder_name":"NCI NIH HHS","grant_id":"P30 CA142543","title":null},{"funder_name":"Varian Medical Systems","grant_id":"","title":null}],"total_grants":2,"fwci":5.404,"citation_percentile":0.96390255,"influential_citations":0,"citation_trend":[{"year":2025,"count":2},{"year":2026,"count":4}],"oa_status":"green","license":"https://academic.oup.com/pages/standard-publication-reuse-rights","oa_locations":[{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13338754/","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13338754/","host_type":"repository"},{"url":"https://academic.oup.com/jnci/advance-article-pdf/doi/10.1093/jnci/djaf232/64095840/djaf232.pdf","host_type":"publisher"},{"url":"https://academic.oup.com/jnci/article-pdf/117/12/2488/64095840/djaf232.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1093/jnci/djaf232","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/40833933","host_type":"repository"}],"fields_of_study":["Head and Neck Cancer Studies","Advanced Radiotherapy Techniques","Oral health in cancer treatment"],"mesh_terms":["Squamous Cell Carcinoma of Head and Neck","Adult","Aged","Female","Head and Neck Neoplasms","Humans","Male","Middle Aged","Prospective Studies","Quality of Life","Radiotherapy Planning, Computer-Assisted","Xerostomia","Cone-Beam Computed Tomography","Chemoradiotherapy","Radiotherapy, Image-Guided"],"keywords":["Quality of life (healthcare)","Head and neck","Randomized controlled trial","Radiation therapy","Phase (matter)","Medicine","Internal medicine","Surgery","Physics","Nursing"],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"nct"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-31T14:44:01.576169Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}