Journal of Radiation Research最新文献

{"title":"Inhibition of mitochondrial RNA polymerase sensitizes cancer cells to radiation by inhibiting mitochondrial respiration.","authors":"Sachiko Tsunoda, Yukina Osawa, Noriko Hosoya","doi":"10.1093/jrr/rrag021","DOIUrl":"10.1093/jrr/rrag021","url":null,"abstract":"<p><p>Radiotherapy is a cornerstone of cancer treatment, but its efficacy is limited by tumor radioresistance and toxicity to normal cells. Thus, radiosensitizing agents that selectively target cancer-specific pathways are needed. Mitochondria contain their own deoxyribonucleic acid (DNA) that encodes proteins essential for oxidative phosphorylation (OXPHOS), the primary energy source for cell growth and survival. Recently, IMT1, a specific inhibitor of mitochondrial transcription targeting mitochondrial RNA polymerase (POLRMT), was developed and shown to suppress tumor growth in several cancers overexpressing POLRMT. However, the effect of combining IMT1 with radiation remains uncharacterized. Here, we show that IMT1 enhances radiosensitivity in cancer cells by inhibiting mitochondrial respiration. We inhibited POLRMT by administrating sublethal dose of IMT1 in OXPHOS-dependent cancer cell lines HeLa, A549, MDA-MB-468, HCT116, A431 and AN3CA, and observed increased radiosensitivity. While radiation alone upregulated mitochondrial respiration, IMT1 abolished this capacity when combined with radiation, showing very low oxygen consumption rates in all respiratory states. IMT1 enhanced radiation-induced apoptosis, but did not affect DNA damage repair and cell cycle regulation. Supplementation with galactose rescued hyper-radiosensitivity induced by IMT1. These findings support the mechanistic link between impaired mitochondrial respiration and radiosensitization induced by POLRMT inhibition. The radiosensitizing effect of IMT1 was not observed in normal cell lines RPE1 and HME1 and the glycolysis-dominant cancer cell line HT1080, suggesting that OXPHOS-dominant cancers would profit most from POLRMT inhibition. Thus, this study presents a novel therapeutic strategy that may improve the efficacy of radiotherapy in OXPHOS-dependent cancer cells while minimizing damage to normal cells.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"339-356"},"PeriodicalIF":2.1,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of online adaptive SBRT boost with 1.5-T MR-Linac for cervical cancer patients unsuitable for brachytherapy: a planning study.","authors":"Kota Abe, Kei Ito, Miho Watanabe, Masato Tsuneda, Yukio Fujita, Takashi Uno","doi":"10.1093/jrr/rrag013","DOIUrl":"10.1093/jrr/rrag013","url":null,"abstract":"<p><p>This study aimed to evaluate the effectiveness of online adaptive treatment (ADT) planning for stereotactic body radiotherapy (SBRT) boost on a 1.5-T MR-Linac in cervical cancer patients ineligible for brachytherapy, compared with the conventional position-alignment (PA) assumed dose distributions. This retrospective analysis included 15 treatment plans from five patients, each receiving 21.0 Gy in three fractions. Daily magnetic resonance imaging (MRIs) were used to compare target and organ-at-risk (OAR) doses between ADT and PA dose distributions. The planning target volume (PTV) was defined as the high-risk clinical target volume (HR-CTV) plus a 3 mm margin. OARs included the bladder, bowel bag, and planning organ-at-risk volume (PRV) for rectum and sigmoid. Reference plans prioritized OAR constraints while maximizing target coverage; the intended PTV D90% range was 18.9-21.6 Gy. PA doses were reconstructed by dose warping based on alignment of the anterior rectal wall between daily and pretreatment MRIs, whereas ADT plans were reoptimized on the daily MRIs. HR-CTV decreased by 1.6%-41.5% between the planning MRI and the first treatment fraction. ADT plans improved PTV D90%, achieved better target coverage and met all OAR constraints, whereas PA plans showed dose constraint exceedance across the three fractions, with mean excess doses of 6.89 ± 4.39 Gy to PRV-sigmoid and 5.76 ± 3.33 Gy to PRV-rectum. In conclusion, 1.5-T MR-Linac based SBRT boost with daily online adaptation enhanced tumor coverage and reduced OAR doses, supporting MR-guided online adaptive radiotherapy as a promising option for patients ineligible for brachytherapy.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"467-472"},"PeriodicalIF":2.1,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and treatment outcomes of simultaneous definitive chemoradiotherapy for elderly patients with synchronous hypopharyngeal and esophageal squamous cell carcinoma.","authors":"Yuki Wada, Tetsugaku Shinozaki, Satoshi Kumagai, Tasuku Kume, Tomochika Sato, Noriko Takagi, Akiyuki Wakita, Yusuke Sato, Yohei Kawasaki, Takechiyo Yamada, Tamotsu Matsuhashi, Katsunori Iijima, Naoko Mori","doi":"10.1093/jrr/rrag023","DOIUrl":"10.1093/jrr/rrag023","url":null,"abstract":"<p><p>Hypopharyngeal and esophageal squamous cell carcinoma may occur synchronously; however, optimal treatment strategies, particularly for elderly patients, remain undefined. We evaluated the feasibility and outcomes of simultaneous definitive chemoradiotherapy in this population. This single-institution retrospective study included patients aged ≥65 years who received definitive chemoradiotherapy for synchronous hypopharyngeal and esophageal squamous cell carcinomas between January 2002 and December 2022. Definitive chemoradiotherapy completion rate, objective response, overall survival, progression-free survival and adverse events were assessed. Fifteen patients were included (median age, 71 years; range, 67-85); all patients had an Eastern Cooperative Oncology Group performance status of 0 or 1. The clinical stages of the carcinomas ranged from early to locally advanced, with the hypopharynx being the advanced site in seven patients (47%), the esophagus in six (40%) and both sites equally in two (13%). The definitive chemoradiotherapy regimen comprised three-dimensional conformal radiotherapy with 70 Gy in 35 fractions for hypopharyngeal carcinomas and 60 Gy in 30 fractions for esophageal carcinomas, with concurrent systemic chemotherapy, the most common being cisplatin/fluorouracil (seven patients, 47%). All patients completed the planned radiotherapy; although six patients (40%) required temporary radiotherapy suspension. Thirteen patients (87%) completed the planned chemotherapy. All patients achieved complete or partial response. The 2-year overall survival and progression-free survival rates were both 56%. All patients experienced grade ≥ 2 adverse events, but they were tolerable. Simultaneous definitive chemoradiotherapy is feasible and demonstrates favorable outcomes for elderly patients with synchronous hypopharyngeal and esophageal squamous cell carcinomas.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"436-443"},"PeriodicalIF":2.1,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restorative effect of Rehmanniae radix praeparata on T-cell and NK-cell-mediated immune reconstitution in mice following radiation-induced injury.","authors":"Xiaodan Zheng, Hongyun Lan, Yuhai Hu, Tianyun Qiu, Hairui Hou, Peifu Tian","doi":"10.1093/jrr/rrag020","DOIUrl":"10.1093/jrr/rrag020","url":null,"abstract":"<p><p>Functional impairment of T and NK cells following irradiation (IR) undermine anti-tumor immune responses. This study aimed to investigate the characteristics of T-cell and NK-cell reconstitution in mice following low-dose radiation-induced injury and the restorative effects of Rehmanniae Radix Praeparata (RRP). At various time points post-IR, splenic/thymic indices, complete blood count and CD3+ T, CD4+ T, CD8+ T and NK cells, as well as CD80, CD86, MHC-I and MHC-II were assessed. Type 1 T helper (Th1), Type 1 cytotoxic (Tc1), Type 1 NK (NK1), regulatory T (Treg) and Th17 cells along with IL-12, IL-15, T-bet and foxP3 were also evaluated with or without RRP treatment. Additionally, a B16 melanoma lung metastasis model in irradiated mice was used to confirm the restorative effects of RRP. CD3+, CD4+, CD8+ T and NK cells decreased significantly on Days 4 to 6 and largely recovered by Days 9 to 11 post-IR. The expression of CD80, CD86 and MHC-II reduced on Day 6 and recovered by Day 11. However, interferon (IFN)-γ production by Th1, Tc1 and NK1 cells remained lower, whereas Tregs were elevated. RRP effectively enhanced IFN-γ production from Th1, Tc1 and NK1 cells and suppressed Tregs by increasing T-bet and decreasing foxP3 expression, thereby significantly reduced the tumor burden. These findings suggest that T-Cell and NK-Cell-mediated inefficient reconstitution following IR was characterized by an decrease of Th1, Tc1 and NK1 cells and an increase of Tregs, RRP effectively promoted the functional reconstitution of T-cell and NK-cell subsets, thereby enhancing anti-tumor immunity after IR.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"327-338"},"PeriodicalIF":2.1,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning-based dose prediction in proton beam therapy for hepatocellular carcinoma: comparison of network architectures and loss functions.","authors":"Shuta Ogawa, Noriyuki Kadoya, Takahiro Kato, Ryohei Kato, Ryota Tozuka, Yuki Narita, Sho Oyama, Masao Murakami, Keiichi Jingu","doi":"10.1093/jrr/rrag026","DOIUrl":"10.1093/jrr/rrag026","url":null,"abstract":"<p><p>In proton beam therapy (PBT) for hepatocellular carcinoma (HCC), deep learning (DL)-based dose prediction offers clinical value by providing immediate reference dose distributions as a guideline tool for treatment planners and enabling virtual PBT dose assessment at institutions lacking PBT facilities to support clinical decision-making. This study proposes a dose gradient-aware DL training approach and a beam arrangement-free framework that predicts dose distributions from computed tomography (CT) images and target/organs-at-risk structures without requiring beam arrangement inputs. Using data from 172 HCC patients, we systematically compared 20 DL models combining five architectures with four loss functions, including a novel dose gradient-aware loss capturing PBT-specific dose distribution characteristics arising from the Bragg peak. Prediction accuracy was evaluated using dose metrics for clinical target volume, planning target volume, and normal liver, 10% dose region volume assessment, visual examination, Dice similarity coefficient (DSC) for 10% dose region, and dose-volume histogram (DVH) analysis. DL models employing dose gradient-aware loss demonstrated reduced prediction errors in target volume dose metrics, achieved the lowest errors in 10% dose region volume when combined with U-Net (MAE: 35.4 cm3, RMSE: 51.3 cm3), attained the highest DSC (0.88 ± 0.05), showed the closest DVH agreement with clinical plans for both target structures and normal liver. A comprehensive evaluation consistently confirmed the superiority of dose gradient-aware loss across all metrics, demonstrating the importance of physics-informed, dose gradient-aware learning for accurate PBT dose distribution prediction. Particularly, DL models combining simple architectures with dose gradient-aware loss predicted doses that closely approximated clinical doses in PBT.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"369-383"},"PeriodicalIF":2.1,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative analysis of autophagic flux reveals radiation-induced activation of SQSTM1-mediated degradation of protein aggregates and ER-phagy.","authors":"Takahito Moriwaki, Tsuyoshi Masuda","doi":"10.1093/jrr/rrag025","DOIUrl":"10.1093/jrr/rrag025","url":null,"abstract":"<p><p>Autophagy is an evolutionarily conserved process that degrades and recycles intracellular components through lysosomes, thereby maintaining cellular homeostasis under stress conditions. Although radiation is known to influence autophagy, most previous studies have relied on static marker expression rather than quantitative evaluation of autophagic flux. In the present study, we quantitatively analyzed autophagic flux in hTERT/RPE-1 cells exposed to γ-rays (0.5-4 Gy) using both bafilomycin A1-based assays and HaloTag reporter systems that visualize lysosomal degradation. LC3-based total autophagic flux remained unchanged even at 4 Gy, indicating that lysosomal function is preserved after irradiation. In contrast, SQSTM1-dependent selective autophagy increased significantly at doses of 2 Gy or higher, suggesting enhanced clearance of radiation-induced protein aggregates. HaloTag-based analyses further revealed that γ-irradiation induced mitophagy and ER-phagy in a dose-dependent manner, consistent with activation of oxidative stress and unfolded protein response pathways. These findings demonstrate that ionizing radiation does not globally suppress autophagy but selectively activates organelle-specific autophagy, particularly SQSTM1-mediated ER-phagy. The selective activation of these quality-control pathways likely contributes to maintaining cellular integrity and stress adaptation following irradiation. Quantitative flux analysis thus provides new insight into the hierarchical regulation of autophagy and its role in cellular survival and repair mechanisms after radiation exposure.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"357-368"},"PeriodicalIF":2.1,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Development of Linear Interpolation System for SMK Model Parameters Evaluated from Cellular-Scale Simulation (LISMEC) and its application to BNCT dosimetry.","authors":"","doi":"10.1093/jrr/rrag027","DOIUrl":"10.1093/jrr/rrag027","url":null,"abstract":"","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"485"},"PeriodicalIF":2.0,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton beam therapy for patients with distal cholangiocarcinoma: a multicenter prospective registry study (Influence of age factor).","authors":"Hideya Yamazaki, Kei Shibuya, Takuya Kimoto, Motohisa Suzuki, Masao Murakami, Kazuki Terashima, Takashi Iizumi, Masaru Wakatsuki, Takashi Ogino, Masaru Takagi, Masayuki Araya, Sae Matsumoto, Hiroyuki Ogino, Takayuki Hashimoto, Hidehiro Hojo, Nobuyoshi Fukumitsu, Takeshi Yanagi","doi":"10.1093/jrr/rrag018","DOIUrl":"10.1093/jrr/rrag018","url":null,"abstract":"<p><p>This study aimed to investigate the role of proton beam therapy (PT) in patients with unresectable distal cholangiocarcinoma (dCCA), with a special focus on elderly patients. We analyzed data from an updated multi-institutional prospective registry that included all Japanese proton beam facilities. The endpoints were local control (LC), progression-free survival (PFS), overall survival (OS) and toxicity. We included 36 patients with unresectable dCCA who were treated with PT at a median prescribed dose of 60 Gy (RBE) in 30 fractions. With a median follow-up of 12.4 months, the median survival time was 18.9 months, and the 1-year OS were 68.8%. The 1-year LC and PFS rates were 80.6 and 42.7%, respectively. The 1-year OS, LC and PFS rates for elderly patients (aged ≥80 years) were 65.6, 82.3 and 40.9%, respectively, showing no significant difference compared to younger patients (OS: 74.1%, P = 0.853; LC: 78.7%, P = 0.708; PFS: 45.5%, P = 0.654). However, four patients (11.1%) experienced grade ≥3 PT-related adverse reactions, exclusively among elderly patients (4/24 = 16.6% vs. 0/12 = 0% in younger patients, P = 0.278). These reactions were significantly higher with prescribed doses of equivalent 2-Gy fractions (EQD2)>60 Gy (3/6 = 50%) than with EQD2 ≤ 60 Gy (1/30 = 3.3%, P = 0.0104). PT showed good efficacy and acceptable toxicity for unresectable dCCA, even in patients aged ≥80 years, who showed outcomes similar to those of their younger counterparts. However, for elderly patients, a higher prescribed dose of EQD2 ≥60 Gy should be used with caution.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"412-419"},"PeriodicalIF":2.1,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of CyberKnife stereotactic radiotherapy for localized prostate cancer: comparison of 35 Gy in 5 fractions and 36 Gy in 4 fractions.","authors":"Jiyoon Lim, Yoon Y Jo, Sumin Lee, Yeon J Kim","doi":"10.1093/jrr/rrag017","DOIUrl":"10.1093/jrr/rrag017","url":null,"abstract":"<p><p>This retrospective study evaluated the clinical outcomes of two CyberKnife (CK) stereotactic body radiation therapy (SBRT) regimens in patients with localized prostate cancer (LPC). A total of 249 patients were treated, with 123 receiving 35 Gy in 5 fractions and 126 receiving 36 Gy in 4 fractions, with a median follow-up of 50 months. The primary endpoint was the incidence of grade ≥2 genitourinary (GU) and gastrointestinal (GI) toxicities, assessed using CTCAE Version 5.0. Secondary endpoints included 3-year biochemical recurrence-free survival (BCRFS), locoregional recurrence-free survival (LRRFS) and distant metastasis-free survival (DMFS). To address baseline imbalances between groups, inverse probability of treatment weighting (IPTW) was applied. Acute grade 2 GU toxicities occurred in 19 patients (7.6%) and chronic grade 2 in 15 patients (6.0%). Acute and chronic grade 2 GI toxicities were rare, occurring in 3 (1.2%) and 2 (0.8%) patients, respectively. There were no significant differences in cumulative GU or GI toxicity rates between fractionation regimens either before or after IPTW adjustment. After IPTW, the 3-year BCRFS was 96.5% in the 5-fraction group and 96.8% in the 4-fraction groups (P = 0.571). The 3-year LRRFS rates were similarly favorable (99.2% vs. 100%). The 3-year DMFS was 100% in the 5-fraction group and 97.5% in the 4-fraction group (P = 0.058). Overall, CK-SBRT using 36 Gy in 4 fractions was well tolerated, with low rates of treatment-related toxicity and no statistically significant differences in oncologic outcomes between regimens. Longer follow-up is required to determine the long-term efficacy of this dose-escalation strategy.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"402-411"},"PeriodicalIF":2.1,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular pulmonary arterial fiducial marker placement for particle radiotherapy using proton or carbon-ion beams for lung cancer.","authors":"Kazuki Terashima, Tomoyuki Gentsu, Daiki Takahashi, Yoshiro Matsuo, Yasue Niwa, Yusuke Demizu, Sunao Tokumaru, Tomoaki Okimoto","doi":"10.1093/jrr/rrag022","DOIUrl":"10.1093/jrr/rrag022","url":null,"abstract":"<p><p>This study evaluated the safety, feasibility and efficacy of endovascular pulmonary arterial fiducial marker (EVFM) placement for image-guided particle therapy using proton or carbon-ion beams in patients with primary or metastatic lung cancer. Methods: A 5F catheter system was used to insert platinum coil markers via the right femoral vein into a distal pulmonary artery near the tumor under fluoroscopic guidance. Tumor-to-marker distances, marker migration and therapy completion were assessed. From July 2016 to January 2019, 54 patients (38 men, 16 women; median age, 71 years) with 46 primary and 8 metastatic lung tumors underwent marker placement. Tumors were located in 33 right and 21 left lobes, with a median diameter of 22 mm. Ten patients received proton therapy, and 44 received carbon-ion therapy. There were no marker placement related complications. Transient arrhythmias occurred only when the guide wire passed through the right ventricle. Tumor-to-marker distances ranged from 0-17 mm (median, 5 mm). Migration during irradiation was minimal (median, 0 mm); one case showed a 4-mm shift due to lung deformation, not marker displacement. All patients completed scheduled therapy without marker migration. EVFM placement is a feasible and safe alternative to computed tomography- or bronchoscopy-guided fiducial marker placement, offering accurate localization with minimal complications or marker migration in particle therapy for lung cancer.</p>","PeriodicalId":16922,"journal":{"name":"Journal of Radiation Research","volume":" ","pages":"430-435"},"PeriodicalIF":2.1,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}