Simultaneous Integrated Boost (SIB) vs. Sequential Boost in Head and Neck Cancer (HNC) Radiotherapy: A Radiomics-Based Decision Proof of Concept
Round 1
Reviewer 1 Report
See my comments in the attached docx.
Comments for author File: 
Comments.pdf
Author Response
Dear Reviewer,
Thank you for the detailed and pertinent analysis of the article. It was very useful to analyze some references (including those related to the selection of cases for proton therapy, a technique not available in our country) but also those related to dose-outcome relationship and confounding factors.
1. We completed the data by including tools from redaction of patient outcomes in the last newly included sub-paragraph, as well as the indicated references
2. The data related to AI based modes were also included in the last newly introduced chapter, and the references indicated and we completed the incomplete data related to the population by marking the addition with yellow
3. At the suggestion of reviewer 2, we compiled data related to the final results of the recently published RTOG 00-22 study and added other results related to NTCP models and QoL based NTCP, all data entered and related references being marked in blue; we corrected the topic and modified certain expressions that we considered inappropriate, especially in the introduction. We also explained what we consider "classical radiomic features" insertion also marker wih yellow
Hoping that you will appreciate the changes, we are waiting for new recommendations to improve the article.
Kind regards,
Camil Mirestean
Reviewer 2 Report
This is an extensive review of amn important issue.
Please address the following comments:
1. Mohan R et al (PMID 10701741, 2000) reported that IMRT dose distributions are most conformal with SIB, as in sequential plans the boost does not take into account the dose distributions delivered in the first plan. This is a major factor that needs to be added.
2. Eisbruch A et al (PMID 21592678, 2011) reported on NTCPs of the pharyngeal constrictors when their sparing was prospectively planned using SIB. The benefits in this report seem to exceed tose reported in references 14-16.
3. Regarding your citation of RTOG 0022: long term results have recently been presented (Garden AS (IJROBP 2021:111;3, Suppl 1, page S143) with excellent results including dysphagia
Author Response
Dear Reviewer,
Thank you for the detailed and pertinent analysis of the article. At the suggestion of reviewer 1, we have completed the data including tools from redaction of patient outcomes and AI based modes pitfalls in the last newly included subsection, as well as the indicated references.
We compiled data related to the final results of the recently published RTOG 00-22 study and added other results from the indicated references, the related additions being marked in blue and the minor corrections and additions in the text in yellow. We have also introduced paragraphs and references marked with blue. Hoping that you will appreciate the changes, we are waiting for new recommendations to improve the article
Kind regards,
Camil Mirestean
