Precision Radiation Oncology最新文献

{"title":"Low versus high dose of postoperative radiotherapy for locally advanced esophageal squamous cell carcinoma: a propensity score-matched analysis.","authors":"Qiwei Yao, Hongying Zheng, Shuyun Huang, Mingqiang Lin, Jun Yang, Jiancheng Li","doi":"10.1002/pro6.1192","DOIUrl":"10.1002/pro6.1192","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the effect of different postoperative radiotherapy doses on the prognosis of patients with esophageal squamous cell carcinoma (ESCC).</p><p><strong>Methods: </strong>A total of 199 patients (aged 18-75 years) with locally advanced ESCC who underwent esophagectomy and postoperative radiotherapy/chemoradiotherapy at the Fujian Cancer Hospital between July 2008 and January 2018 were included. Based on the postoperative radiotherapy dose, the patients were divided into a low-dose group (50-50.4 Gy; median dose 50 Gy) and a high-dose group (>50.4 Gy; median dose 60 Gy). Neoadjuvant and adjuvant chemotherapy regimens included PF (fluorouracil and cisplatin) and TP (paclitaxel and cisplatin) regimens. Patients were followed-up every 3 months in the first 2 years after surgery, every 6 months for the next 3 years, and then subsequently once a year. The primary endpoints were overall survival (OS) and progression-free survival (PFS) rates. The propensity-score matching (PSM) method was applied to identify a 1:1, well-balanced matched cohort with 33 patients in each group for survival comparison.</p><p><strong>Results: </strong>Among the 199 patients enrolled in this study, 144 and 55 were in the low-dose and high-dose groups, respectively. Univariate and multivariate analyses showed that pathological N classification, vascular tumor emboli, and postoperative radiotherapy dose were independent prognostic factors for both OS and PFS, all <i>p</i> < 0.05. Before PSM, the OS and the PFS of the low-dose group were significantly longer than those of the high-dose group, both <i>p</i> < 0.05. After PSM, better OS and PFS rates were observed in the low-dose group, both <i>p</i> < 0.05. The results showed that patients with pathological stages N0-2 or N3, negative surgical margins, and no vascular tumor emboli could obtain a significant benefit in both OS and PFS after treatment with a low dose of postoperative radiotherapy (50-50.4 Gy). In the subgroup with positive surgical margins, treatment with a low dose of postoperative radiotherapy offered a non-significant survival benefit compared to treatment with a high dose of postoperative radiotherapy.</p><p><strong>Conclusions: </strong>Our study revealed that for patients with ESCC, the low-dose group (50-50.4 Gy) had a significantly higher OS and PFS than the high-dose group (>50.4 Gy). It was suggested that 50-50.4 Gy might be the recommended postoperative radiotherapy dose for ESCC patients.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"7 1","pages":"101-110"},"PeriodicalIF":0.0,"publicationDate":"2023-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45688218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of radiomics in lung immuno-oncology.","authors":"Weisi Yan, Chen Quan, Waleed F Mourad, Jianda Yuan, Zheng Shi, Jun Yang, Qiuxia Lu, Jie Zhang","doi":"10.1002/pro6.1191","DOIUrl":"10.1002/pro6.1191","url":null,"abstract":"<p><p>Radiomics is a rapidly evolving field of research that extracts and analyzes quantitative features within medical images. Those features are termed as radiomic features that can characterize a tumor in a comprehensive and quantitative manner with regard to its internal structure and heterogeneity. Radiomic features can be used, alone or in combination with demographic, histological, genomic, or proteomic data, for predicting prognosis or treatment response. Immunotherapy, or immune-oncology, is the study of cancer treatment by taking advantage of the body's immune system to prevent, control, and eliminate cancer. In this review, we first provide a brief introduction to both radiomics and immune-oncology in lung cancer. Then, we discuss the need for developing immune-oncology biomarkers, and the advantages of radiomics in identifying biomarkers related to immunotherapy. We also discuss potential areas in and out of tumors, such as the intra-tumoral hypoxic region and tumor microenvironment, where radiomic markers might be extracted, as well as a potential application of radiomic biomarkers in clinical lung cancer management. Finally, we present radiation and immune modulation in non-small cell lung cancer, clinical trials and their design to incorporate radiomic biomarkers, and radiomics-guided precision radiation therapy.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"7 1","pages":"128-136"},"PeriodicalIF":0.0,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47406940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Definitive chemoradiotherapy in elderly patients with esophageal cancer: Safety and outcome.","authors":"Ivane Kiladze, Lika Chkhaidze, Aleksandre Iovashvili, Eteri Natelauri, Besik Sokurashvili, Elene Mariamidze, Nikoloz Kacheishvili, Branislav Jeremic","doi":"10.1002/pro6.1190","DOIUrl":"10.1002/pro6.1190","url":null,"abstract":"<p><p><b>Objective</b>: The efficacy and safety of definitive chemoradiotherapy (dCRT) for elderly patients with unresectable esophageal cancer (EC) are not yet fully understood. We conducted this study to evaluate the outcome and toxicity in elder patients (65 years and over) of unresectable EC treated with dCRT. <b>Methods</b>: From four Georgian cancer centers with a radiation oncology department, we identified 44 elderly patients with EC suitable according to the study criteria. Overall survival (OS) was estimated from the beginning of treatment and toxicity scored using CTCAE 5.0 criteria. <b>Results</b>: The median age of patients was 70.0 years (range 65-83 years), with male predominance (77.3%) and 59% of patients were with Eastern Cooperative Oncology Group (ECOG) performance status 1. Because of significant dysphagia (grade 3-4) nine patients underwent intervention (stenting or gastrostomy) before dCRT. More than two-thirds of patients were squamous cell histological type (77.3%). Localization of tumors was equally distributed between the middle and lower parts of the esophagus (38.6%) and in 26 patients (59.1%) tumor length was more than 5 cm. The majority of patients had stage III disease (61.4%). Median survival was 16.0 months (95% confidence interval [CI] 0-35.9). OS at 12 and 24 months was 53.7% and 43.6%, respectively. Fifteen patients (34%) were alive from 2.1 to 5.4 years after treatment. A statistically significant difference (<i>p</i> = 0.011) in median OS was found between patients who received full (not reached) <i>versus</i> overall survival (OS) was 9.0 months in patients who received nonfull dose of radiotherapy (RT) (95% CI 2.79-15.2). Additional analysis between age subgroups revealed that elder subgroup patients (>75 years) had the highest OS, compared to younger (65-70 years) and intermediate groups (71-75 years) (<i>p</i> = 0.001). The most common adverse events were grade 3-4 leukopenia (43.2%), anemia (29.5%), and esophagitis (27.3%). <b>Conclusion</b>: The results of our study support the feasibility and efficacy of dCRT for unresectable EC in carefully selected elderly patients. Survival was correlated to complete dose of RT and therefore accurate selection of patients is crucial for better long-term survival. Our study showed that chronological age alone does not reflect a patient's ability to tolerate dCRT. Toxicity of dCRT is always a very important issue and patient selection must be very cautious in geriatric patients, although dCRT might benefit highly selected patients.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"7 1","pages":"51-58"},"PeriodicalIF":0.0,"publicationDate":"2023-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42014226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating bone marrow dosimetry with the addition of bone marrow structures to the medical internal radiation dose phantom.","authors":"Kristine L Ferrone, Charles E Willis, Fada Guan, Jingfei Ma, Leif E Peterson, Stephen F Kry","doi":"10.1002/pro6.1189","DOIUrl":"10.1002/pro6.1189","url":null,"abstract":"<p><strong>Background: </strong>Reliable estimates of radiation dose to bone marrow are critical to understanding the risk of radiation-induced cancers. Although the medical internal radiation dose phantom is routinely used for dose estimation, bone marrow is not defined in the phantom. Consequently, methods of indirectly estimating bone marrow dose have been implemented based on dose to surrogate volumes or average dose to soft tissue.</p><p><strong>Methods: </strong>In this study, new bone marrow structures were implemented and evaluated to the medical internal radiation dose phantom in geant4, offering improved fidelity. The dose equivalent to the bone marrow was calculated across medical, occupational, and space radiation exposure scenarios, and compared with results using prior indirect estimation methods.</p><p><strong>Conclusion: </strong>Our results show that bone marrow dose may be overestimated by up to a factor of three when using the traditional methods when compared with the improved fidelity medical internal radiation dose method, specifically at clinical x-ray energies.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"7 1","pages":"27-35"},"PeriodicalIF":0.0,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47286378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric response of Gafchromic^™ EBT-XD film to therapeutic protons.","authors":"Fada Guan, Xiaochun Wang, Ming Yang, Emily Draeger, Dae Han, Kiminori Iga, Fanqing Guo, Luis Perles, Yuting Li, Narayan Sahoo, Radhe Mohan, Zhe Chen","doi":"10.1002/pro6.1187","DOIUrl":"10.1002/pro6.1187","url":null,"abstract":"<p><p>EBT-XD model of Gafchromic^™ films has a broader optimal dynamic dose range, up to 40 Gy, compared to its predecessor models. This characteristic has made EBT-XD films suitable for high-dose applications such as stereotactic body radiotherapy and stereotactic radiosurgery, as well as ultra-high dose rate FLASH radiotherapy. The purpose of the current study was to characterize the dependence of EBT-XD film response on linear energy transfer (LET) and dose rate of therapeutic protons from a synchrotron. A clinical spot-scanning proton beam was used to study LET dependence at three dose-averaged LET (LET_d) values of 1.0 keV/µm, 3.6 keV/µm, and 7.6 keV/µm. A research proton beamline was used to study dose rate dependence at 150 Gy/second in the FLASH mode and 0.3 Gy/second in the non-FLASH mode. Film response data from LET_d values of 0.9 keV/µm and 9.0 keV/µm of the proton FLASH beam were also compared. Film response data from a clinical 6 MV photon beam were used as a reference. Both gray value method and optical density (OD) method were used in film calibration. Calibration results using a specific OD calculation method and a generic OD calculation method were compared. The four-parameter NIH Rodbard function and three-parameter rational function were compared in fitting the calibration curves. Experimental results showed that the response of EBT-XD film is proton LET dependent but independent of dose rate. Goodness-of-fit analysis showed that using the NIH Rodbard function is superior for both protons and photons. Using the \"specific OD + NIH Rodbard function\" method for EBT-XD film calibration is recommended.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"7 1","pages":"15-26"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10586355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49417719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adding the X-ray Bragg reflection physical process in crystal to the Geant4 Monte Carlo simulation toolkit, part I: reflection from a crystal slab.","authors":"Fada Guan, Makoto Asai, Dirk A Bartkoski, Michael Kleckner, Ze'ev Harel, Mohammad Salehpour","doi":"10.1002/pro6.1188","DOIUrl":"10.1002/pro6.1188","url":null,"abstract":"<p><p>X-ray diffraction from a solid crystal shows the wave nature of photons. It is an important electromagnetic (EM) physics process when X-ray photons interact with a crystal. Bragg diffraction, often called Bragg reflection, is a special case of the general form of X-ray diffraction, known as Laue diffraction. When the Bragg's law is met, the incident photon beam is reflected from the crystal plane behaving as a specular reflection at the Bragg angle. However, the Bragg reflection physical process has not been integrated into the general-purpose Monte Carlo simulation toolkit Geant4 for particle physics. In the current study, we developed a new EM physical process class \"G4CrystalBraggReflection\" and a new EM physical model class \"G4DarwinDynamicalModel\" for modeling the Bragg reflection physical process within a crystal. We added the Bragg reflection physical process to the EM physics category of Geant4. The preliminary results of photon tracking in a silicon crystal slab have shown the feasibility of simulating the Bragg reflection process in addition to the standard EM processes in the framework of Geant4.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"7 1","pages":"59-66"},"PeriodicalIF":0.0,"publicationDate":"2023-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42770143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation of DNA damage using Geant4-DNA: an overview of the \"molecularDNA\" example application.","authors":"Konstantinos P Chatzipapas, Ngoc Hoang Tran, Milos Dordevic, Sara Zivkovic, Sara Zein, Wook-Geun Shin, Dousatsu Sakata, Nathanael Lampe, Jeremy M C Brown, Aleksandra Ristic-Fira, Ivan Petrovic, Ioanna Kyriakou, Dimitris Emfietzoglou, Susanna Guatelli, Sébastien Incerti","doi":"10.1002/pro6.1186","DOIUrl":"10.1002/pro6.1186","url":null,"abstract":"<p><strong>Purpose: </strong>The scientific community shows great interest in the study of DNA damage induction, DNA damage repair, and the biological effects on cells and cellular systems after exposure to ionizing radiation. Several <i>in silico</i> methods have been proposed so far to study these mechanisms using Monte Carlo simulations. This study outlines a Geant4-DNA example application, named \"molecularDNA\", publicly released in the 11.1 version of Geant4 (December 2022).</p><p><strong>Methods: </strong>It was developed for novice Geant4 users and requires only a basic understanding of scripting languages to get started. The example includes two different DNA-scale geometries of biological targets, namely \"cylinders\" and \"human cell\". This public version is based on a previous prototype and includes new features, such as: the adoption of a new approach for the modeling of the chemical stage, the use of the standard DNA damage format to describe radiation-induced DNA damage, and upgraded computational tools to estimate DNA damage response.</p><p><strong>Results: </strong>Simulation data in terms of single-strand break and double-strand break yields were produced using each of the available geometries. The results were compared with the literature, to validate the example, producing less than 5% difference in all cases. Conclusion: \"molecularDNA\" is a prototype tool that can be applied in a wide variety of radiobiology studies, providing the scientific community with an open-access base for DNA damage quantification calculations. New DNA and cell geometries for the \"molecularDNA\" example will be included in future versions of Geant4-DNA.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"7 1","pages":"4-14"},"PeriodicalIF":0.0,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42652922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy of early-stage breast cancer.","authors":"Cedric X Yu","doi":"10.1002/pro6.1183","DOIUrl":"10.1002/pro6.1183","url":null,"abstract":"<p><p>Breast cancer is the most prevalent disease for women. With advances in breast cancer screening, most breast cancers are now diagnosed in the early stages. With knowledge of different subtypes and their behavior, breast cancer treatment has become more individualized. Radiation therapy as one of the mainstays of breast cancer treatment has also been evolving. This review attempts to provide a summary of the most influential clinical studies that have driven the technological advances in radiation therapy for early-stage breast cancer.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"7 1","pages":"67-79"},"PeriodicalIF":0.0,"publicationDate":"2023-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45714565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes after salvage external beam radiotherapy combined with interstitial brachytherapy for locally advanced, recurrent endometrial cancer.","authors":"Asmara Waheed, Robyn Banerjee, Tyler Meyer, Sarah Quirk, Corinne Doll, Philip McGeachy, Tien Phan, Michael Roumeliotis, Kevin Martell","doi":"10.1002/pro6.1185","DOIUrl":"10.1002/pro6.1185","url":null,"abstract":"<p><p>Salvage external beam radiation therapy (EBRT) followed by interstitial brachytherapy is commonly used to treat patients with vaginal recurrence of endometrial cancer. The evidence for this is typically limited to case series treating small volumes of disease. For the present study, 12 consecutive patients with locally advanced, biopsy-proven vaginal recurrence after surgically treated endometrial cancer who received salvage EBRT (45 Gy in 25 daily fractions to microscopic disease and 55-57.5 Gy to gross nodal disease) with magnetic resonance-guided interstitial brachytherapy (20-21 Gy in 3 fractions over 2 days) were retrospectively reviewed. The median tumor size of recurrent disease on magnetic resonance imaging was 5 (3-6) cm. Three (25%) tumors involved the bladder wall, three (25%) involved the urethra, and four (33%) extended to the pelvic sidewall. Four (25%) patients had gross nodal disease. On follow-up, no (0%) patient developed local recurrence. One patient (8%) developed nodal recurrence outside of the radiotherapy treatment volume and then distant metastases, and one patient (8%) developed distant metastasis 2.5 years post-treatment and subsequently died from the disease. No (0%) other deaths were reported. Zero patients (0%) developed grade ≥4 bowel or bladder toxicity. These data support EBRT with interstitial brachytherapy using modern techniques for locally advanced, vaginal recurrences of endometrial cancer.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"7 1","pages":"45-50"},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48354527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of dose calculation accuracy on inverse linear energy transfer optimization for intensity-modulated proton therapy.","authors":"Mei Chen, Wenhua Cao, Pablo Yepes, Fada Guan, Falk Poenisch, Cheng Xu, Jiayi Chen, Yupeng Li, Ivan Vazquez, Ming Yang, X Ronald Zhu, Xiaodong Zhang","doi":"10.1002/pro6.1179","DOIUrl":"10.1002/pro6.1179","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effect of dose calculation accuracy on inverse linear energy transfer (LET) optimization for intensity-modulated proton therapy, and to determine whether adding more beams would improve the plan robustness to different dose calculation engines.</p><p><strong>Methods: </strong>Two sets of intensity-modulated proton therapy plans using two, four, six, and nine beams were created for 10 prostate cancer patients: one set was optimized with dose constraints (DoseOpt) using the pencil beam (PB) algorithm, and the other set was optimized with additional LET constraints (LETOpt) using the Monte Carlo (MC) algorithm. Dose distributions of DoseOpt plans were then recalculated using the MC algorithm, and the LETOpt plans were recalculated using the PB algorithm. Dosimetric indices of targets and critical organs were compared between the PB and MC algorithms for both sets of plans.</p><p><strong>Results: </strong>For DoseOpt plans, dose differences between the PB and MC algorithms were minimal. However, the maximum dose differences in LETOpt plans were 11.11% and 15.85% in the dose covering 98% and 2% (D2) of the clinical target volume, respectively. Furthermore, the dose to 1 cc of the bladder differed by 11.42 Gy (relative biological effectiveness). Adding more beams reduced the discrepancy in target coverage, but the errors in D2 of the structure were increased with the number of beams.</p><p><strong>Conclusion: </strong>High modulation of LET requires high dose calculation accuracy during the optimization and final dose calculation in the inverse treatment planning for intensity-modulated proton therapy, and adding more beams did not improve the plan robustness to different dose calculation algorithms.</p>","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":"7 1","pages":"36-44"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11935249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41811741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}