{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:31:15Z","timestamp":1782898275153,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T00:00:00Z","timestamp":1608249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009950","name":"Ministry of Education","doi-asserted-by":"publisher","award":["19K08088"],"award-info":[{"award-number":["19K08088"]}],"id":[{"id":"10.13039\/100009950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009950","name":"Ministry of Education","doi-asserted-by":"publisher","award":["18H02758"],"award-info":[{"award-number":["18H02758"]}],"id":[{"id":"10.13039\/100009950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate potential advantages of adaptive intensity\u2010modulated proton beam therapy (A\u2010IMPT) by comparing it to adaptive intensity\u2010modulated X\u2010ray therapy (A\u2010IMXT) for nasopharyngeal carcinomas (NPC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten patients with NPC treated with A\u2010IMXT (step and shoot approach) and concomitant chemotherapy between 2014 and 2016 were selected. In the actual treatment, 46\u00a0Gy in 23 fractions (46Gy\/23Fx.) was prescribed using the initial plan and 24Gy\/12Fx was prescribed using an adapted plan thereafter. New treatment planning of A\u2010IMPT was made for the same patients using equivalent dose fractionation schedule and dose constraints. The dose volume statistics based on deformable images and dose accumulation was used in the comparison of A\u2010IMXT with A\u2010IMPT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The means of the D<jats:sub>mean<\/jats:sub> of the right parotid gland (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), right TM joint (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), left TM joint (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), oral cavity (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), supraglottic larynx (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), glottic larynx (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), , middle PCM (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0371), interior PCM (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), cricopharyngeal muscle (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.03643), and thyroid gland (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.00216), in A\u2010IMPT are lower than those of A\u2010IMXT, with statistical significance. The means of, D<jats:sub>0.03cc<\/jats:sub>, and D<jats:sub>mean<\/jats:sub> of each sub portion of auditory apparatus and D<jats:sub>30%<\/jats:sub> for Eustachian tube and D<jats:sub>0.5cc<\/jats:sub> for mastoid volume in A\u2010IMPT are significantly lower than those of A\u2010IMXT. The mean doses to the oral cavity, supraglottic larynx, and glottic larynx were all reduced by more than 20\u00a0Gy (RBE\u00a0=\u00a01.1).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>An adaptive approach is suggested to enhance the potential benefit of IMPT compared to IMXT to reduce adverse effects for patients with NPC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.13128","type":"journal-article","created":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T22:06:42Z","timestamp":1608329202000},"page":"174-183","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Potential benefits of adaptive intensity\u2010modulated proton therapy in nasopharyngeal carcinomas"],"prefix":"10.1002","volume":"22","author":[{"given":"Hideki","family":"Minatogawa","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Faculty of Medicine and Graduate School of Medicine Hokkaido 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