Developing a web‐based dashboard for adaptive radiotherapy workflows

Purpose Adaptive radiotherapy (ART) is limited by the absence of reliable thresholds to trigger necessary plan adaptation. This work develops and verifies a web‐based, database‐backed dashboard that unifies geometric, dosimetric, and radiobiological metrics to support day‐to‐day ART decisions. Methods Ten retrospectively selected patients were analyzed (Head and Neck (H prostate MR‐linac, n = 5, 5 fx). Daily dose was recalculated on CBCT‐derived pseudo‐CTs (pCT) (H max 0.45 mm). Interfraction Dice mean absolute difference was 0.08 (max 0.83); intrafraction Dice differences were smaller (overall mean residual −0.01). For score card dose endpoints, the largest mean difference was at D99.9% (1.31 Gy; 2.08%—below TG‐114′s 5% action level). Percent‐volume endpoints showed small residuals (overall mean +0.32%); absolute‐volume endpoints were near zero (overall mean +0.05 cm3). Radiobiology residuals were modest (mean: PI +1.78%, P+ −1.11%, PB +0.86%) with occasional outliers (max PI 8.69%). Three metrics reached statistical significance (central point, intra‐/inter‐fraction Dice), but effect sizes were negligible to small. Conclusions The dashboard reproduces geometric, DVH, objective, and radiobiology metrics within acceptable limits relative to MIM, providing a credible foundation for ART decision support. Limitations include the projected DVH being a visualization (not dose accumulation) and radiobiology sensitivity to DVH sampling in steep gradients.