{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T05:50:53Z","timestamp":1774158653028,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["12475343"],"award-info":[{"award-number":["12475343"]}],"id":[{"id":"10.13039\/501100001809","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":[[2026,3]]},"abstract":"Abstract<\/jats:title>\n \n Purpose<\/jats:title>\n This study aimed to evaluate a novel technological platform, Taichi Pro\u2014which integrates a 6\u00a0MV flattening filterfree linear accelerator with a 18 source Rotating Gamma System (RGS) to generate steep dose gradients via multisource focused \u03b3\u2010rays and noncoplanar arcs\u2014for precision radiotherapy in prostate cancer. The work provides evidence to support the clinical adoption of hybridmodality radiotherapy devices.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Fifteen prostate cancer patients were enrolled. For each patient, a dual\u2010modality Taichi Pro plan (RGS focused on the planning gross tumor volume (PGTV) + Linac covering the planning target volume (PTV)) and a Halcyon photon plan (three\u2010arc VMAT) were designed while maintaining clinically tolerable dose to organs at risk (OAR). Comparative assessments included planning target volume (PTV and PGTV) metrics (D\n 95%<\/jats:sub>\n , D\n mean<\/jats:sub>\n , homogeneity index HI, conformity index CI), OAR doses (rectum V\n 40<\/jats:sub>\n \/V\n 60<\/jats:sub>\n \/D\n 2cc<\/jats:sub>\n , bladder V\n 40<\/jats:sub>\n , testis D\n 2cc<\/jats:sub>\n , etc.) and delivery efficiency to evaluate the ability to escalate target dose while sparing adjacent OARs.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n All plans met institutional clinical constraints. Taichi Pro significantly increased PGTV D\n mean<\/jats:sub>\n (79.48\u00a0Gy\u00a0\u00b1\u00a01.75\u00a0Gy) compared to Halcyon (73.25\u00a0Gy\u00a0\u00b1\u00a00.55 24\u00a0Gy,\n P<\/jats:italic>\n \u00a0<\u00a00.001) and D\n max<\/jats:sub>\n (122.74\u00a0Gy\u00a0\u00b1\u00a08.69\u00a0Gy) compared to Halcyon (76.15\u00a0Gy\u00a0\u00b1\u00a00.79\u00a0Gy,\n P<\/jats:italic>\n \u00a0<\u00a00.001), albeit poorer homogeneity (HI: 0.50\u00a0\u00b1\u00a00.09 for Taichi Pro vs. 0.06\u00a0\u00b1\u00a00.01 for Halcyon, though within clinically acceptable limits). Taichi Pro significantly reduced rectum V\n 60<\/jats:sub>\n (3.97%\u00a0\u00b1\u00a03.25%\u00a0vs. Halcyon 7.46%\u00a0\u00b1\u00a04.78%,\n P<\/jats:italic>\n \u00a0=\u00a00.016), and D\n 2cc<\/jats:sub>\n (61.61\u00a0Gy\u00a0\u00b1\u00a05.01\u00a0Gy vs. Halcyon 65.29\u00a0Gy\u00a0\u00b1\u00a04.52\u00a0Gy,\n P<\/jats:italic>\n \u00a0=\u00a00.040). Taichi Pro also significantly reduced testis D\n 2cc<\/jats:sub>\n (2.39\u00a0\u00b1\u00a01.99\u00a0Gy) compared to (3.17\u00a0Gy\u00a0\u00b1\u00a01.40\u00a0Gy,\n P<\/jats:italic>\n \u00a0=\u00a00.006). Halcyon demonstrated significantly shorter beam\u2010on time (1.81\u00a0\u00b1\u00a00.23 minutes vs. 5.05\u00a0\u00b1\u00a01.59 minutes for Taichi Pro,\n P<\/jats:italic>\n \u00a0<\u00a00.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Utilizing the steep dose gradient characteristic of the RGS, the Taichi Pro dual\u2010modality system effectively achieved target dose escalation while simultaneously improving sparing of adjacent OARs. This approach holds the potential for enhancing patient treatment outcomes and quality of life.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/acm2.70532","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T20:58:32Z","timestamp":1773003512000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An X\u2010ray and \u03b3\u2010ray combination strategy to exploit steep dose gradients for improved prostate cancer radiotherapy: A dosimetric comparison of Taichi Pro and Halcyon"],"prefix":"10.1002","volume":"27","author":[{"given":"Kuo","family":"Li","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Physics & Technology Cancer Hospital of Shandong First Medical University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Physics & Technology Cancer Hospital of Shandong First Medical University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Physics & Technology Cancer Hospital of Shandong First Medical University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weipeng","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Physics & Technology Cancer Hospital of Shandong First Medical University Jinan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shihao","family":"Wang","sequence":"additional","affiliation":[{"name":"Our United Corp Xi'an China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenjiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Physics & Technology Cancer Hospital of Shandong First Medical University Jinan 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