{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T06:45:53Z","timestamp":1782629153971,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007452","name":"Wu Jieping Medical Foundation","doi-asserted-by":"publisher","award":["320.6750.2025\u201006\u2010215"],"award-info":[{"award-number":["320.6750.2025\u201006\u2010215"]}],"id":[{"id":"10.13039\/100007452","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":[[2026,6]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n This study is a retrospective replanning study. For primary liver cancer, radiotherapy is vital for inoperable patients; however, dosimetric data comparing the rotating gamma ray system (RGS) and volumetric modulated arc therapy (VMAT) remains scarce, complicating clinical technique selection. Notably, RGS refers to a body gamma ray platform designed for extracranial stereotactic body radiotherapy (SBRT) \u2014 this is distinct from the \u201cGamma Knife\u201d system, which is specifically dedicated to intracranial radiosurgery.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n To compare the dosimetric differences between RGS and VMAT techniques in the radiotherapy of primary liver cancer.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n 30 patients with primary liver cancer, underwent both RGS and VMAT planning. Analyzed planning target volume (PTV) parameters: coverage (Target Coverage Index, TCI), max\/mean\/min dose (D\n max<\/jats:sub>\n \/D\n mean<\/jats:sub>\n \/D\n min<\/jats:sub>\n ), conformity (Conformity Index, CI), homogeneity (Homogeneity Index, HI), gradient index (Gradient Index, GI). Evaluated liver doses: D\n mean<\/jats:sub>\n , V\n 20<\/jats:sub>\n , V\n 5<\/jats:sub>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n In this dosimetric comparison of 30 primary liver cancer patients, RGS plans demonstrated significantly higher maximum tumor dose (D\n max<\/jats:sub>\n : 10253\u00a0\u00b1\u00a0196 cGy vs. VMAT: 6807\u00a0\u00b1\u00a0315 cGy;\n P<\/jats:italic>\n \u00a0<\u00a00.001), mean tumor dose (D\n mean<\/jats:sub>\n median [IQR]: RGS: 7410 cGy [7222\u20137493] vs. VMAT: 5780 cGy [5675\u20135870];\n P<\/jats:italic>\n \u00a0<\u00a00.001), and target coverage (median [IQR]: RGS: 100% [99\u2013100] vs. VMAT: 98% [98\u201398];\n P<\/jats:italic>\n \u00a0<\u00a00.001) compared to VMAT plans. RGS also exhibited a steeper dose fall\u2010off (GI: 3.32\u00a0\u00b1\u00a00.37\u00a0vs. VMAT: 5.84\u00a0\u00b1\u00a01.12;\n P<\/jats:italic>\n \u00a0<\u00a00.001). Conversely, VMAT achieved superior conformity (CI: 0.83\u00a0\u00b1\u00a00.06 vs. RGS: 0.63\u00a0\u00b1\u00a00.08;\n P<\/jats:italic>\n \u00a0<\u00a00.001), homogeneity (HI: 0.23\u00a0\u00b1\u00a00.05\u00a0vs. RGS: 0.57\u00a0\u00b1\u00a00.05;\n P<\/jats:italic>\n \u00a0<\u00a00.001), and significantly reduced low\u2010dose liver irradiation (V\n 5<\/jats:sub>\n : 23.7%\u00a0\u00b1\u00a010.2%\u00a0vs. RGS: 34.4%\u00a0\u00b1\u00a012.8%;\n P<\/jats:italic>\n \u00a0<\u00a00.001). The mean liver dose was also significantly lower with VMAT (616\u00a0\u00b1\u00a0253 cGy vs. RGS: 677\u00a0\u00b1\u00a0314 cGy;\n P<\/jats:italic>\n \u00a0=\u00a00.039). No significant differences were observed in minimum tumor dose (D\n min<\/jats:sub>\n ) or liver V\n 20<\/jats:sub>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In radiotherapy for primary liver cancer, the rotating gamma ray system offers the characteristic of highly focused central dose with rapid peripheral dose fall\u2010off, ensuring high tumor dose while better protecting adjacent liver tissues. VMAT provides superior conformity and homogeneity, with better control of the mean liver dose and low\u2010dose irradiation volumes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/acm2.70581","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:15:13Z","timestamp":1781586913000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A dosimetric analysis of a rotating gamma ray system and volumetric modulated arc therapy in retrospective replanning for primary liver cancer"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0459-6267","authenticated-orcid":false,"given":"Jiarui","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Chifeng Tumor Hospital Inner Mongolia Autonomous Region Chifeng China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siming","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Chifeng Tumor Hospital Inner Mongolia Autonomous Region Chifeng China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingran","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Chifeng Tumor Hospital Inner Mongolia Autonomous Region Chifeng China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Chifeng Tumor Hospital Inner Mongolia Autonomous Region Chifeng China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liying","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Chifeng Tumor Hospital Inner Mongolia Autonomous Region Chifeng China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Chifeng Tumor Hospital Inner Mongolia Autonomous Region Chifeng China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiyang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Chifeng Tumor Hospital Inner Mongolia Autonomous Region Chifeng China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Chifeng Tumor Hospital Inner Mongolia Autonomous Region Chifeng China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Chifeng Tumor Hospital Inner Mongolia Autonomous Region Chifeng China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.691354"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1033497"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/bioengineering10020215"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3438081"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24338"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1088\/2057-1976\/adecab"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrclinonc.2009.188"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000421-198212000-00014"},{"key":"e_1_2_11_10_1","unstructured":"StatPearls Publishing.Use of the Child\u2010Pugh score in liver disease.Stat Pearls.2025. 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