Academic Journal
Optimizing allocation of limited proton fractions via NTCP-optimized combined proton-photon radiotherapy.
| Τίτλος: | Optimizing allocation of limited proton fractions via NTCP-optimized combined proton-photon radiotherapy. |
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| Συγγραφείς: | Wang W; School of Electrical and Information Engineering, Changsha University of Science and Technology, Changsha, China.; State Key Laboratory of Advanced Electromagnetic Technology, School of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan, China.; Department of Radiation Oncology, Medical Center, University of Kansas, Kansas City, USA., Li W; Department of Radiation Oncology, Medical Center, University of Kansas, Kansas City, USA., Lin Y; Department of Radiation Oncology, Medical Center, University of Kansas, Kansas City, USA., Liu X; State Key Laboratory of Advanced Electromagnetic Technology, School of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan, China., Qin B; State Key Laboratory of Advanced Electromagnetic Technology, School of Electrical and Electronic Engineering, Huazhong University of Science and Technology, Wuhan, China. bin.qin@hust.edu.cn., Gao H; Department of Radiation Oncology, Medical Center, University of Kansas, Kansas City, USA. hgao2@kumc.edu. |
| Πηγή: | Physical and engineering sciences in medicine [Phys Eng Sci Med] 2026 Sep; Vol. 49 (3), pp. 1483-1493. Date of Electronic Publication: 2026 Aug 04. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Springer Country of Publication: Switzerland NLM ID: 101760671 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2662-4737 (Electronic) Linking ISSN: 26624729 NLM ISO Abbreviation: Phys Eng Sci Med Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Switzerland : Springer, [2020]- |
| Ιατρικοί όροι (MeSH): | Proton Therapy*/methods , Photons*/therapeutic use , Radiotherapy, Intensity-Modulated* , Dose Fractionation, Radiation*, Radiotherapy Planning, Computer-Assisted/methods ; Humans ; Protons ; Radiotherapy Dosage |
| Περίληψη: | Compared to photon radiotherapy (RT), proton RT is less widely available and more costly. To maximize the normal-tissue complication probability (NTCP) benefit of limited proton resources at a population level, this work introduces a novel NTCP-optimized combined proton-photon treatment (NTCP-CPPT) approach that can achieve the OAR-sparing benefits in terms of reaching desired NTCP thresholds with the minimal proton fraction. NTCP-optimized intensity-modulated proton therapy (NTCP-IMPT) and NTCP-optimized intensity-modulated radiation therapy (NTCP-IMRT) plans are generated via the NTCP-optimized treatment planning based on physical dose and NTCP objectives. For each patient, a minimal proton fraction is determined for the NTCP-CPPT plan as a combination of NTCP-IMPT and NTCP-IMRT plans, while still retaining the sum-NTCP threshold for the patient to be justified for the proton access. For comparison, conventional CPPT (CONV-CPPT) plans are obtained by a combination of conventional IMRT (CONV-IMRT) and conventional IMPT (CONV-IMPT) plans that are solely optimized based on physical dose optimization. Compared to CONV-CPPT, NTCP-CPPT reduced the average proton fractions from 18 to 3 without compromising physical dose objectives, while both NTCP-CPPT and CONV-CPPT plans maintained a sum-NTCP below 20% relative to CONV-IMRT. Additionally, NTCP-CPPT, using an average of 22 proton fractions out of 35, maintained the same sum-NTCP as CONV-IMPT required 35 proton fractions. To increase patient access to proton RT, a novel combined proton-photon treatment called NTCP-CPPT is proposed that can provide a minimal number of proton fractions while still retaining sufficient OAR-sparing benefits to justify the proton access. (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Conflict of interest: The authors declare no conflict of interest. Ethics approval: This retrospective study was approved by the Institutional Review Board of UT Southwestern Medical Center. The requirement for informed consent was waived because the study involved retrospective analysis of existing de-identified clinical imaging data. |
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| Grant Information: | R01 CA261964 United States CA NCI NIH HHS; R37 CA250921 United States CA NCI NIH HHS; R37CA250921 Foundation for the National Institutes of Health; R01CA261964 Foundation for the National Institutes of Health |
| Contributed Indexing: | Keywords: Combined proton–photon radiotherapy; Minimize proton fractions; NTCP optimization |
| Substance Nomenclature: | 0 (Protons) |
| Entry Date(s): | Date Created: 20260804 Date Completed: 20261005 Latest Revision: 20261008 |
| Update Code: | 20261008 |
| PubMed Central ID: | PMC13638690 |
| DOI: | 10.1007/s13246-026-01759-7 |
| PMID: | 42550398 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2662-4737 |
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| DOI: | 10.1007/s13246-026-01759-7 |