{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:06:11Z","timestamp":1790697971811,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to quantitatively evaluate the efficacy of plan adaptation in stereotactic body proton therapy (SBPT) for pancreatic cancer using daily CT\u2010based dose evaluation, investigate the appropriate adaptation frequency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective planning study included 10 patients previously treated with X\u2010ray stereotactic body radiation therapy for pancreatic cancer. An initial SBPT plan was created for each patient, using robust optimization with two posterior oblique beams. The prescribed dose was D90 \u2265 40\u00a0Gy(RBE) to the CTV_EVAL (the CTV excluding the gastrointestinal [GI] tract plus a 5\u2010mm margin), delivered in five fractions. Daily dose evaluation (DDE) was performed using five daily CT (dCT) images per patient. An adaptive plan (AP) was generated and applied to subsequent fractions if target coverage or organs at\u2010risk (OARs) constraints were not met; otherwise, the initial plan (IP) was employed. Non\u2010adaptation (NA) and daily adaptation (DA) strategies were compared in terms of dose\u2010volume metrics, accumulated doses, tumor control probability (TCP), and normal tissue complication probability (NTCP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across 50 fractions, plan adaptation was necessary in 21 fractions (42%), with a mean of 2.1 adaptations per patient. DA significantly improved target coverage on DDE compared with NA (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). Doses to the OARs, particularly the GI tract, were significantly reduced with DA. In the accumulated dose, DA led to a significantly higher D90 of CTV_EVAL (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), whereas doses to the OARs demonstrated no significant differences between strategies. TCP was significantly improved with DA, whereas NTCP demonstrated no significant differences for any OARs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The DA strategy, according to DDE, improved target dose coverage while maintaining or reducing doses to the OARs. These findings indicate that appropriately frequent plan adaptation\u2014an average of 2.1 adaptations per patient\u2014may improve SBPT safety and efficacy for pancreatic cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70644","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T10:56:13Z","timestamp":1779965773000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the efficacy of plan adaptation in stereotactic body proton therapy for pancreatic cancer"],"prefix":"10.1002","volume":"27","author":[{"given":"Yuto","family":"Matsuo","sequence":"first","affiliation":[{"name":"Graduate School of Biomedical Science and Engineering Hokkaido University  Sapporo Japan"},{"name":"Department of Medical Physics Hokkaido University Hospital  Sapporo 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