{
  "abstract": "Background and purpose: Tangential volumetric modulated arc therapy may combine rotational conformality with tangential beam geometry. We compared tangential with continuous-arc volumetric modulated arc therapy for postoperative breast radiotherapy with deliberately matched target coverage, focusing on cardiac and contralateral low-dose exposure. Material and methods: Fifty-four patients were included in this paired planning study. For each patient, the clinically delivered tangential plan and a matched continuous-arc plan were evaluated. Target coverage was matched by clinical-target-volume D95% and planning-target-volume D2%. Dose-volume endpoints, low-dose area-under-the-curve metrics, delta dose-volume histograms, subgroup interactions, and mechanistic organ-equivalent-dose surrogates were evaluated. Results: Target coverage and homogeneity were comparable, while conformity was higher with tangential planning ( p = 0.006). Tangential planning reduced mean heart dose from 1.34 to 1.17 Gy ( p < 0.001), contralateral lung mean dose from 0.94 to 0.57 Gy, and contralateral breast mean dose from 1.16 to 0.76 Gy (both p < 0.001). Mechanistic organ-equivalent-dose surrogates were reduced by 37.0% for the contralateral lung and 32.7% for the contralateral breast. Exploratory interaction analyses did not identify statistically significant interactions by laterality, deep-inspiration breath hold, simultaneous integrated boost, or regional nodal irradiation. Conclusions: In a clinically heterogeneous paired cohort that included boost irradiation, regional nodal irradiation, and deep-inspiration breath hold, tangential volumetric modulated arc therapy reduced cardiac and contralateral low-dose exposure while preserving target coverage.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiotherapy, Hannover Medical School, Carl-Neuberg-Strasse 1, Hannover, 30625, Germany",
    "Corresponding author."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Anne Caroline Knöchelmann"
    },
    {
      "affs": [
        0
      ],
      "name": "Mirko Fischer"
    },
    {
      "affs": [
        0
      ],
      "name": "Kathrin Burchardt"
    },
    {
      "affs": [
        0
      ],
      "name": "Daniela Meinecke"
    },
    {
      "affs": [
        1
      ],
      "name": "Jan-Niklas Becker"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2w2wjp6f0j7t2.bib",
  "cited_by": 0,
  "doi": "10.1016/j.phro.2026.101115",
  "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2405631626002150",
  "id": "2w2wjp6f0j7t2",
  "issns": [
    "2405-6316"
  ],
  "landing_url": "https://doi.org/10.1016/j.phro.2026.101115",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R895-920"
    ],
    [
      "lcc",
      "RC254-282"
    ],
    [
      "openalex",
      "3108|Advanced Radiotherapy Techniques"
    ]
  ],
  "openalex": "W7225091211",
  "pdf_url": "https://www.phiro.science/article/S2405-6316(26)00215-0/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-05",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/2w2wjp6f0j7t2.ris",
  "sources": [
    {
      "first_seen": "2026-11-05T14:21:20Z",
      "native_id": "036a2407255a4b87bd8cabeb1cc69c05",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.phro.2026.101115"
    }
  ],
  "subjects": [
    {
      "field": "physics",
      "origin": "openalex:3108|Advanced Radiotherapy Techniques",
      "subfield": "applied-instrumentation"
    }
  ],
  "title": "Tangential volumetric modulated arc therapy reduces cardiac and contralateral low-dose exposure compared with continuous volumetric modulated arc therapy in postoperative breast radiotherapy",
  "title_text": "Tangential volumetric modulated arc therapy reduces cardiac and contralateral low-dose exposure compared with continuous volumetric modulated arc therapy in postoperative breast radiotherapy",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T14:20:33Z",
  "url": "https://research.draconitic.com/paper/2w2wjp6f0j7t2",
  "venue": "Physics and Imaging in Radiation Oncology",
  "versions": []
}