{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:34:07Z","timestamp":1786977247584,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP15ck0106035"],"award-info":[{"award-number":["JP15ck0106035"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP17ck0106303"],"award-info":[{"award-number":["JP17ck0106303"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP20ck0106626"],"award-info":[{"award-number":["JP20ck0106626"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP24ck0106924"],"award-info":[{"award-number":["JP24ck0106924"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>For delivering high radiation doses to pancreatic tumors, organ motion management is indispensable; however, studies on this are limited. We aimed to evaluate the efficacy and safety of dynamic tumor tracking (DTT) moderately hypofractionated intensity\u2010modulated radiotherapy (IMRT) in patients with locally advanced pancreatic cancer (LAPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with histological confirmation for LAPC were included. A linac system, which was mounted with a gimbal function, was used for DTT\u2010IMRT. The prescribed dose was 48\u2009Gy in 15 fractions. The primary endpoint was the 1\u2010year rate of freedom from locoregional progression (FFLP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>DTT\u2010IMRT was successfully administered in 25 patients enrolled from four institutions. The median range of respiratory motion during DTT\u2010IMRT was 9.8\u2009mm (range: 3.5\u201327.3\u2009mm), and the median tracking accuracy was 2.6\u2009mm (range: 0.7\u20135.2\u2009mm). With a median follow\u2010up period of 13.9\u2009months, the 1\u2010year FFLP rate was 75.3% (lower limit of one\u2010sided 80% confidence interval [CI]: 60.2%), which satisfied the predetermined primary endpoint. One\u2010year locoregional progression\u2010free survival, progression\u2010free survival, and overall survival were 56.0% (95% CI: 34.8%\u201372.7%), 44.0% (95% CI: 24.5%\u201361.9%), and 60.0% (95% CI: 38.4%\u201376.1%), respectively. Regarding nonhematologic toxicities, grade 3 acute gastrointestinal (GI) toxicity was observed in two patients (8%), and two patients (8%) each experienced grade 3 late GI and non\u2010GI toxicities. No grade 4 or 5 nonhematologic toxicities were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DTT moderately hypofractionated IMRT shows preferable locoregional control without significant toxicity in patients with LAPC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>UMIN000017521<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.70648","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T06:58:30Z","timestamp":1738738710000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Multi\u2010Institutional Phase\n                    <scp>II<\/scp>\n                    Study on the Efficacy and Safety of Dynamic Tumor\u2010Tracking, Moderately Hypofractionated Intensity\u2010Modulated Radiotherapy in Patients With Locally Advanced Pancreatic Cancer"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6665-2245","authenticated-orcid":false,"given":"Michio","family":"Yoshimura","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology and Image\u2010Applied Therapy, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Hiraoka","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Image\u2010Applied Therapy, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Kokubo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Kobe City Medical Center General Hospital  Kobe 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhiro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical Physics, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobutaka","family":"Mukumoto","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Image\u2010Applied Therapy, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine Kyoto University  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8135-8746","authenticated-orcid":false,"given":"Takashi","family":"Mizowaki","sequence":"additional","affiliation":[{"name":"Department 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