Academic Journal
Comparison of in-field secondary cancer risk based on therapeutic proton dose between proton arc therapy and intensity-modulated proton therapy in lung cancer patients.
| Τίτλος: | Comparison of in-field secondary cancer risk based on therapeutic proton dose between proton arc therapy and intensity-modulated proton therapy in lung cancer patients. |
|---|---|
| Συγγραφείς: | Xu Y; School of Physics, University of Electronic Science and Technology, Chengdu, China.; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China., Chen W; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.; The College of Nuclear Technology and Automation Engineering, Chengdu University of Technology, Chengdu, China., Wu J; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China., Guo H; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China., Zeng F; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.; The College of Nuclear Technology and Automation Engineering, Chengdu University of Technology, Chengdu, China., Zhang T; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.; Institute of Automatic and Molecular Physics, Sichuan University, Chengdu, China., Yang F; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China., Huang X; School of Physics, University of Electronic Science and Technology, Chengdu, China.; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China., Zhang D; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China., Wang X; School of Physics, University of Electronic Science and Technology, Chengdu, China.; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China. |
| Πηγή: | Journal of applied clinical medical physics [J Appl Clin Med Phys] 2026 Sep; Vol. 27 (9), pp. e70793. |
| Τύπος έκδοσης: | Journal Article; Comparative Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley on behalf of American Association of Physicists in Medicine Country of Publication: United States NLM ID: 101089176 Publication Model: Print Cited Medium: Internet ISSN: 1526-9914 (Electronic) Linking ISSN: 15269914 NLM ISO Abbreviation: J Appl Clin Med Phys Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2017- : Malden, MA : Wiley on behalf of American Association of Physicists in Medicine Original Publication: Reston, VA : American College of Medical Physics, c2000- |
| Ιατρικοί όροι (MeSH): | Lung Neoplasms*/radiotherapy , Radiotherapy, Intensity-Modulated*/methods , Radiotherapy, Intensity-Modulated*/adverse effects , Organs at Risk*/radiation effects , Proton Therapy*/adverse effects , Proton Therapy*/methods , Neoplasms, Radiation-Induced*/etiology , Neoplasms, Radiation-Induced*/epidemiology , Radiotherapy Planning, Computer-Assisted*/methods , Neoplasms, Second Primary*/etiology , Neoplasms, Second Primary*/epidemiology, Humans ; Radiotherapy Dosage ; Female ; Retrospective Studies ; Male ; Prognosis ; Aged ; Middle Aged ; Risk Assessment |
| Περίληψη: | Background: Proton arc therapy (PAT) is an emerging delivery modality that delivers proton beams through continuous gantry rotation combined with spot scanning. Compared with intensity-modulated proton therapy (IMPT), PAT improves target conformity and spares organs at risk. However, the dynamic multi-angle irradiation pattern may alter the low-dose region distribution: the low-dose bath expands while the integral dose decreases. The net effect on secondary cancer risk, especially in radiosensitive lungs, remains unclear. Quantitative risk assessment is essential for clinical translation of PAT. Purpose: To quantitatively compare secondary lung cancer risk between PAT and IMPT using organ equivalent dose (OED) and lifetime attributable risk (LAR) models, and to assess cross-population robustness across China, France, Sweden, and Germany. Methods: Data from 25 lung cancer patients (60 Gy/30 fractions) were retrospectively included. For each patient, robustly optimized IMPT and PAT plans were generated with a 3 mm setup and 3% range uncertainties across 21 error scenarios. Dosimetric parameters-ipsilateral lung INLINEMATH , INLINEMATH , and mean dose; whole lungs INLINEMATH , INLINEMATH , and mean dose; and esophageal mean dose-were compared between the two techniques. The mechanistic OED model (with repopulation factor R) and its simplified linear model were used to calculate OED for the ipsilateral lung, both lungs, and the esophagus. LAR was computed by integrating excess absolute risk over the remaining lifetime using patient age, sex, and population-specific parameters (China, France, Sweden, Germany). Relative risk was assessed via the LAR ratio (IMPT/PAT). Paired t-tests or Wilcoxon tests were used with p < 0.05. Results: Under the linear model, PAT produced statistically markedly but modest reductions in absolute LAR for lungs (p < 0.001). Under the mechanistic model, reductions were markedly only in certain populations: ipsilateral lung in France (p = 0.001), Sweden (p < 0.001), Germany (p = 0.003); whole lungs in France (p = 0.046) and Sweden (p = 0.014); but not in China (p = 0.083; p = 1.000) or Germany for whole lungs (p = 0.317). No marked esophageal differences (p > 0.05). LAR ratios were consistent across countries (ipsilateral lung: 1.07-1.09; esophagus: 1.04-1.13), demonstrating robustness. Conclusions: PAT does not increase the modeled in-field secondary cancer risk in the lungs compared with IMPT and shows comparable risk for the esophagus. The risk reduction trend is robust across Chinese and European populations. These findings suggest that PAT does not increase modeled secondary lung cancer risk compared with IMPT and may even provide a modest risk reduction, providing quantitative evidence for clinical application. (© 2026 The Author(s). Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.) |
| References: | Radiother Oncol. 2020 Aug;149:212-218. (PMID: 32464163) Int J Radiat Oncol Biol Phys. 2007 Jul 15;68(4):1212-21. (PMID: 17637394) Phys Med Biol. 2010 Dec 7;55(23):6987-98. (PMID: 21076196) Radiother Oncol. 2012 Oct;105(1):122-6. (PMID: 21993405) Cancer. 2020 Aug 1;126(15):3560-3568. (PMID: 32426866) Radiother Oncol. 2024 Oct;199:110421. (PMID: 38997093) Front Bioeng Biotechnol. 2020 May 07;8:306. (PMID: 32457880) Med Phys. 2025 May;52(5):3461-3470. (PMID: 39971724) Clin Respir J. 2024 May;18(5):e13760. (PMID: 38725324) Front Oncol. 2019 Sep 06;9:877. (PMID: 31555602) Ann ICRP. 2007;37(2-4):1-332. (PMID: 18082557) Rep Pract Oncol Radiother. 2022 Mar 22;27(1):170-175. (PMID: 35402031) Genes (Basel). 2011 Nov 29;2(4):1033-49. (PMID: 24710304) Int J Radiat Oncol Biol Phys. 2013 Sep 1;87(1):46-52. (PMID: 23778197) Clin Lung Cancer. 2025 Nov;26(7):527-540. (PMID: 40796462) Proc Natl Acad Sci U S A. 2005 Sep 13;102(37):13040-5. (PMID: 16150705) Theor Biol Med Model. 2011 Jul 26;8:27. (PMID: 21791103) J Natl Compr Canc Netw. 2024 May;22(4):249-274. (PMID: 38754467) Front Oncol. 2021 Jul 12;11:698537. (PMID: 34327139) Med Phys. 2009 Apr;36(4):1138-43. (PMID: 19472619) Acta Oncol. 2024 Oct 29;63:805-815. (PMID: 39473175) Int J Surg. 2024 Aug 01;110(8):4617-4623. (PMID: 38716897) Health Phys. 2012 Nov;103(5):586-9. (PMID: 23032888) Radiother Oncol. 2019 Aug;137:130-136. (PMID: 31100606) Z Med Phys. 2009;19(4):236-50. (PMID: 19962082) Semin Radiat Oncol. 2015 Apr;25(2):100-9. (PMID: 25771414) Radiother Oncol. 2024 Oct;199:110434. (PMID: 39009306) Z Med Phys. 2025 Nov;35(4):393-400. (PMID: 40713449) |
| Grant Information: | 2024ZD0519901 National Science and Technology Major Project; 2025ZYD0167 Central Government's Special Program to Guide Local Scientific and Technological Development of Sichuan Province |
| Contributed Indexing: | Keywords: intensity‐modulated proton therapy; lung cancer; proton arc therapy; secondary cancer risk |
| Entry Date(s): | Date Created: 20260910 Date Completed: 20260910 Latest Revision: 20260914 |
| Update Code: | 20260914 |
| PubMed Central ID: | PMC13559473 |
| DOI: | 10.1002/acm2.70793 |
| PMID: | 42717736 |
| Βάση Δεδομένων: | MEDLINE |
| FullText | Text: Availability: 0 CustomLinks: – Url: https://resolver.ebsco.com/c/fiv2js/result?sid=EBSCO:cmedm&genre=article&issn=15269914&ISBN=&volume=27&issue=9&date=20260901&spage=e70793&pages=e70793&title=Journal of applied clinical medical physics&atitle=Comparison%20of%20in-field%20secondary%20cancer%20risk%20based%20on%20therapeutic%20proton%20dose%20between%20proton%20arc%20therapy%20and%20intensity-modulated%20proton%20therapy%20in%20lung%20cancer%20patients.&aulast=Xu%20Y&id=DOI:10.1002/acm2.70793 Name: Full Text Finder (for New FTF UI) (ns324271) Category: fullText Text: Full Text Finder MouseOverText: Full Text Finder |
|---|---|
| Header | DbId: cmedm DbLabel: MEDLINE An: 42717736 AccessLevel: 3 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Comparison of in-field secondary cancer risk based on therapeutic proton dose between proton arc therapy and intensity-modulated proton therapy in lung cancer patients. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AU" term="%22Xu+Y%22">Xu Y</searchLink>; School of Physics, University of Electronic Science and Technology, Chengdu, China.; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.<br /><searchLink fieldCode="AU" term="%22Chen+W%22">Chen W</searchLink>; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.; The College of Nuclear Technology and Automation Engineering, Chengdu University of Technology, Chengdu, China.<br /><searchLink fieldCode="AU" term="%22Wu+J%22">Wu J</searchLink>; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.<br /><searchLink fieldCode="AU" term="%22Guo+H%22">Guo H</searchLink>; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.<br /><searchLink fieldCode="AU" term="%22Zeng+F%22">Zeng F</searchLink>; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.; The College of Nuclear Technology and Automation Engineering, Chengdu University of Technology, Chengdu, China.<br /><searchLink fieldCode="AU" term="%22Zhang+T%22">Zhang T</searchLink>; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.; Institute of Automatic and Molecular Physics, Sichuan University, Chengdu, China.<br /><searchLink fieldCode="AU" term="%22Yang+F%22">Yang F</searchLink>; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.<br /><searchLink fieldCode="AU" term="%22Huang+X%22">Huang X</searchLink>; School of Physics, University of Electronic Science and Technology, Chengdu, China.; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.<br /><searchLink fieldCode="AU" term="%22Zhang+D%22">Zhang D</searchLink>; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China.<br /><searchLink fieldCode="AU" term="%22Wang+X%22">Wang X</searchLink>; School of Physics, University of Electronic Science and Technology, Chengdu, China.; Department of Radiation Oncology, Precision Radiation in Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China. – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22101089176%22">Journal of applied clinical medical physics</searchLink> [J Appl Clin Med Phys] 2026 Sep; Vol. 27 (9), pp. e70793. – Name: TypePub Label: Publication Type Group: TypPub Data: Journal Article; Comparative Study – Name: Language Label: Language Group: Lang Data: English – Name: TitleSource Label: Journal Info Group: Src Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Wiley+on+behalf+of+American+Association+of+Physicists+in+Medicine%22">Wiley on behalf of American Association of Physicists in Medicine </searchLink><i>Country of Publication: </i>United States <i>NLM ID: </i>101089176 <i>Publication Model: </i>Print <i>Cited Medium: </i>Internet <i>ISSN: </i>1526-9914 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2215269914%22">15269914 </searchLink><i>NLM ISO Abbreviation: </i>J Appl Clin Med Phys <i>Subsets: </i>MEDLINE – Name: PublisherInfo Label: Imprint Name(s) Group: PubInfo Data: <i>Publication</i>: 2017- : Malden, MA : Wiley on behalf of American Association of Physicists in Medicine<br /><i>Original Publication</i>: Reston, VA : American College of Medical Physics, c2000- – Name: SubjectMESH Label: MeSH Terms Group: Su Data: <searchLink fieldCode="MM" term="%22Lung+Neoplasms%22">Lung Neoplasms*</searchLink>/<searchLink fieldCode="MM" term="%22Lung+Neoplasms+radiotherapy%22">radiotherapy</searchLink> <br /><searchLink fieldCode="MM" term="%22Radiotherapy%2C+Intensity-Modulated%22">Radiotherapy, Intensity-Modulated*</searchLink>/<searchLink fieldCode="MM" term="%22Radiotherapy%2C+Intensity-Modulated+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Radiotherapy%2C+Intensity-Modulated%22">Radiotherapy, Intensity-Modulated*</searchLink>/<searchLink fieldCode="MM" term="%22Radiotherapy%2C+Intensity-Modulated+adverse+effects%22">adverse effects</searchLink> <br /><searchLink fieldCode="MM" term="%22Organs+at+Risk%22">Organs at Risk*</searchLink>/<searchLink fieldCode="MM" term="%22Organs+at+Risk+radiation+effects%22">radiation effects</searchLink> <br /><searchLink fieldCode="MM" term="%22Proton+Therapy%22">Proton Therapy*</searchLink>/<searchLink fieldCode="MM" term="%22Proton+Therapy+adverse+effects%22">adverse effects</searchLink> <br /><searchLink fieldCode="MM" term="%22Proton+Therapy%22">Proton Therapy*</searchLink>/<searchLink fieldCode="MM" term="%22Proton+Therapy+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Neoplasms%2C+Radiation-Induced%22">Neoplasms, Radiation-Induced*</searchLink>/<searchLink fieldCode="MM" term="%22Neoplasms%2C+Radiation-Induced+etiology%22">etiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Neoplasms%2C+Radiation-Induced%22">Neoplasms, Radiation-Induced*</searchLink>/<searchLink fieldCode="MM" term="%22Neoplasms%2C+Radiation-Induced+epidemiology%22">epidemiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Radiotherapy+Planning%2C+Computer-Assisted%22">Radiotherapy Planning, Computer-Assisted*</searchLink>/<searchLink fieldCode="MM" term="%22Radiotherapy+Planning%2C+Computer-Assisted+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Neoplasms%2C+Second+Primary%22">Neoplasms, Second Primary*</searchLink>/<searchLink fieldCode="MM" term="%22Neoplasms%2C+Second+Primary+etiology%22">etiology</searchLink> <br /><searchLink fieldCode="MM" term="%22Neoplasms%2C+Second+Primary%22">Neoplasms, Second Primary*</searchLink>/<searchLink fieldCode="MM" term="%22Neoplasms%2C+Second+Primary+epidemiology%22">epidemiology</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Radiotherapy+Dosage%22">Radiotherapy Dosage</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Retrospective+Studies%22">Retrospective Studies</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Prognosis%22">Prognosis</searchLink> ; <searchLink fieldCode="MH" term="%22Aged%22">Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Middle+Aged%22">Middle Aged</searchLink> ; <searchLink fieldCode="MH" term="%22Risk+Assessment%22">Risk Assessment</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Background: Proton arc therapy (PAT) is an emerging delivery modality that delivers proton beams through continuous gantry rotation combined with spot scanning. Compared with intensity-modulated proton therapy (IMPT), PAT improves target conformity and spares organs at risk. However, the dynamic multi-angle irradiation pattern may alter the low-dose region distribution: the low-dose bath expands while the integral dose decreases. The net effect on secondary cancer risk, especially in radiosensitive lungs, remains unclear. Quantitative risk assessment is essential for clinical translation of PAT.<br />Purpose: To quantitatively compare secondary lung cancer risk between PAT and IMPT using organ equivalent dose (OED) and lifetime attributable risk (LAR) models, and to assess cross-population robustness across China, France, Sweden, and Germany.<br />Methods: Data from 25 lung cancer patients (60 Gy/30 fractions) were retrospectively included. For each patient, robustly optimized IMPT and PAT plans were generated with a 3 mm setup and 3% range uncertainties across 21 error scenarios. Dosimetric parameters-ipsilateral lung INLINEMATH , INLINEMATH , and mean dose; whole lungs INLINEMATH , INLINEMATH , and mean dose; and esophageal mean dose-were compared between the two techniques. The mechanistic OED model (with repopulation factor R) and its simplified linear model were used to calculate OED for the ipsilateral lung, both lungs, and the esophagus. LAR was computed by integrating excess absolute risk over the remaining lifetime using patient age, sex, and population-specific parameters (China, France, Sweden, Germany). Relative risk was assessed via the LAR ratio (IMPT/PAT). Paired t-tests or Wilcoxon tests were used with p &lt; 0.05.<br />Results: Under the linear model, PAT produced statistically markedly but modest reductions in absolute LAR for lungs (p &lt; 0.001). Under the mechanistic model, reductions were markedly only in certain populations: ipsilateral lung in France (p = 0.001), Sweden (p &lt; 0.001), Germany (p = 0.003); whole lungs in France (p = 0.046) and Sweden (p = 0.014); but not in China (p = 0.083; p = 1.000) or Germany for whole lungs (p = 0.317). No marked esophageal differences (p &gt; 0.05). LAR ratios were consistent across countries (ipsilateral lung: 1.07-1.09; esophagus: 1.04-1.13), demonstrating robustness.<br />Conclusions: PAT does not increase the modeled in-field secondary cancer risk in the lungs compared with IMPT and shows comparable risk for the esophagus. The risk reduction trend is robust across Chinese and European populations. These findings suggest that PAT does not increase modeled secondary lung cancer risk compared with IMPT and may even provide a modest risk reduction, providing quantitative evidence for clinical application.<br /> (© 2026 The Author(s). Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.) – Name: Ref Label: References Group: RefInfo Data: Radiother Oncol. 2020 Aug;149:212-218. (PMID: <searchLink fieldCode="PM" term="%2232464163%22">32464163)</searchLink><br />Int J Radiat Oncol Biol Phys. 2007 Jul 15;68(4):1212-21. (PMID: <searchLink fieldCode="PM" term="%2217637394%22">17637394)</searchLink><br />Phys Med Biol. 2010 Dec 7;55(23):6987-98. (PMID: <searchLink fieldCode="PM" term="%2221076196%22">21076196)</searchLink><br />Radiother Oncol. 2012 Oct;105(1):122-6. (PMID: <searchLink fieldCode="PM" term="%2221993405%22">21993405)</searchLink><br />Cancer. 2020 Aug 1;126(15):3560-3568. (PMID: <searchLink fieldCode="PM" term="%2232426866%22">32426866)</searchLink><br />Radiother Oncol. 2024 Oct;199:110421. (PMID: <searchLink fieldCode="PM" term="%2238997093%22">38997093)</searchLink><br />Front Bioeng Biotechnol. 2020 May 07;8:306. (PMID: <searchLink fieldCode="PM" term="%2232457880%22">32457880)</searchLink><br />Med Phys. 2025 May;52(5):3461-3470. (PMID: <searchLink fieldCode="PM" term="%2239971724%22">39971724)</searchLink><br />Clin Respir J. 2024 May;18(5):e13760. (PMID: <searchLink fieldCode="PM" term="%2238725324%22">38725324)</searchLink><br />Front Oncol. 2019 Sep 06;9:877. (PMID: <searchLink fieldCode="PM" term="%2231555602%22">31555602)</searchLink><br />Ann ICRP. 2007;37(2-4):1-332. (PMID: <searchLink fieldCode="PM" term="%2218082557%22">18082557)</searchLink><br />Rep Pract Oncol Radiother. 2022 Mar 22;27(1):170-175. (PMID: <searchLink fieldCode="PM" term="%2235402031%22">35402031)</searchLink><br />Genes (Basel). 2011 Nov 29;2(4):1033-49. (PMID: <searchLink fieldCode="PM" term="%2224710304%22">24710304)</searchLink><br />Int J Radiat Oncol Biol Phys. 2013 Sep 1;87(1):46-52. (PMID: <searchLink fieldCode="PM" term="%2223778197%22">23778197)</searchLink><br />Clin Lung Cancer. 2025 Nov;26(7):527-540. (PMID: <searchLink fieldCode="PM" term="%2240796462%22">40796462)</searchLink><br />Proc Natl Acad Sci U S A. 2005 Sep 13;102(37):13040-5. (PMID: <searchLink fieldCode="PM" term="%2216150705%22">16150705)</searchLink><br />Theor Biol Med Model. 2011 Jul 26;8:27. (PMID: <searchLink fieldCode="PM" term="%2221791103%22">21791103)</searchLink><br />J Natl Compr Canc Netw. 2024 May;22(4):249-274. (PMID: <searchLink fieldCode="PM" term="%2238754467%22">38754467)</searchLink><br />Front Oncol. 2021 Jul 12;11:698537. (PMID: <searchLink fieldCode="PM" term="%2234327139%22">34327139)</searchLink><br />Med Phys. 2009 Apr;36(4):1138-43. (PMID: <searchLink fieldCode="PM" term="%2219472619%22">19472619)</searchLink><br />Acta Oncol. 2024 Oct 29;63:805-815. (PMID: <searchLink fieldCode="PM" term="%2239473175%22">39473175)</searchLink><br />Int J Surg. 2024 Aug 01;110(8):4617-4623. (PMID: <searchLink fieldCode="PM" term="%2238716897%22">38716897)</searchLink><br />Health Phys. 2012 Nov;103(5):586-9. (PMID: <searchLink fieldCode="PM" term="%2223032888%22">23032888)</searchLink><br />Radiother Oncol. 2019 Aug;137:130-136. (PMID: <searchLink fieldCode="PM" term="%2231100606%22">31100606)</searchLink><br />Z Med Phys. 2009;19(4):236-50. (PMID: <searchLink fieldCode="PM" term="%2219962082%22">19962082)</searchLink><br />Semin Radiat Oncol. 2015 Apr;25(2):100-9. (PMID: <searchLink fieldCode="PM" term="%2225771414%22">25771414)</searchLink><br />Radiother Oncol. 2024 Oct;199:110434. (PMID: <searchLink fieldCode="PM" term="%2239009306%22">39009306)</searchLink><br />Z Med Phys. 2025 Nov;35(4):393-400. (PMID: <searchLink fieldCode="PM" term="%2240713449%22">40713449)</searchLink> – Name: GrantInfo Label: Grant Information Group: Grant Data: 2024ZD0519901 National Science and Technology Major Project; 2025ZYD0167 Central Government's Special Program to Guide Local Scientific and Technological Development of Sichuan Province – Name: SubjectMinor Label: Contributed Indexing Group: Data: <i>Keywords: </i>intensity‐modulated proton therapy; lung cancer; proton arc therapy; secondary cancer risk – Name: DateEntry Label: Entry Date(s) Group: Date Data: <i>Date Created: </i>20260910 <i>Date Completed: </i>20260910 <i>Latest Revision: </i>20260914 – Name: DateUpdate Label: Update Code Group: Date Data: 20260914 – Name: PubmedCentralID Label: PubMed Central ID Group: ID Data: PMC13559473 – Name: DOI Label: DOI Group: ID Data: 10.1002/acm2.70793 – Name: AN Label: PMID Group: ID Data: 42717736 |
| PLink | https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=42717736 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1002/acm2.70793 Languages: – Code: eng Text: English PhysicalDescription: Pagination: StartPage: e70793 Subjects: – SubjectFull: Humans Type: general – SubjectFull: Radiotherapy Dosage Type: general – SubjectFull: Female Type: general – SubjectFull: Retrospective Studies Type: general – SubjectFull: Male Type: general – SubjectFull: Prognosis Type: general – SubjectFull: Aged Type: general – SubjectFull: Middle Aged Type: general – SubjectFull: Risk Assessment Type: general – SubjectFull: Lung Neoplasms radiotherapy Type: general – SubjectFull: Radiotherapy, Intensity-Modulated methods Type: general – SubjectFull: Radiotherapy, Intensity-Modulated adverse effects Type: general – SubjectFull: Organs at Risk radiation effects Type: general – SubjectFull: Proton Therapy adverse effects Type: general – SubjectFull: Proton Therapy methods Type: general – SubjectFull: Neoplasms, Radiation-Induced etiology Type: general – SubjectFull: Neoplasms, Radiation-Induced epidemiology Type: general – SubjectFull: Radiotherapy Planning, Computer-Assisted methods Type: general – SubjectFull: Neoplasms, Second Primary etiology Type: general – SubjectFull: Neoplasms, Second Primary epidemiology Type: general Titles: – TitleFull: Comparison of in-field secondary cancer risk based on therapeutic proton dose between proton arc therapy and intensity-modulated proton therapy in lung cancer patients. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Xu Y – PersonEntity: Name: NameFull: Chen W – PersonEntity: Name: NameFull: Wu J – PersonEntity: Name: NameFull: Guo H – PersonEntity: Name: NameFull: Zeng F – PersonEntity: Name: NameFull: Zhang T – PersonEntity: Name: NameFull: Yang F – PersonEntity: Name: NameFull: Huang X – PersonEntity: Name: NameFull: Zhang D – PersonEntity: Name: NameFull: Wang X IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 09 Text: 2026 Sep Type: published Y: 2026 Identifiers: – Type: issn-electronic Value: 1526-9914 Numbering: – Type: volume Value: 27 – Type: issue Value: 9 Titles: – TitleFull: Journal of applied clinical medical physics Type: main |
| ResultId | 1 |