{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:04:24Z","timestamp":1791201864889,"version":"4.2.0"},"reference-count":48,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,12,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    This study aimed to investigate whether hippocampal avoidance (D\n                    <jats:sub>40<\/jats:sub>\n                    \u2009&lt;\u200915\u2009Gy) could reduce anxiety incidence in patients with nasopharyngeal carcinoma (NPC) undergoing intensity modulated radiation therapy (IMRT), and to dynamically assess the anxiety incidence at 3 and 6\u2009months after radiotherapy. A single\u2010center, single\u2010arm prospective clinical trial was conducted, enrolling eligible NPC patients who underwent hippocampal\u2010sparing IMRT with the hippocampal D\n                    <jats:sub>40<\/jats:sub>\n                    \u2009&lt;\u200915\u2009Gy. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety, and the Mini\u2010Mental State Examination (MMSE) was applied to evaluate cognitive function. Assessments were conducted at pre\u2010radiotherapy, end of radiotherapy, 3\u2010 and 6\u2010month post\u2010radiotherapy. All 37 enrolled patients met the criterion of hippocampal D\n                    <jats:sub>40<\/jats:sub>\n                    \u2009\u2264\u200915\u2009Gy. The incidence of anxiety was 0% (0\/37) at the end of radiotherapy, which was lower than the 30.8% observed in the historical control group with hippocampal D\n                    <jats:sub>40<\/jats:sub>\n                    \u2009&gt;\u200915\u2009Gy (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001). At 3\u2009months post\u2010radiotherapy, no patients developed anxiety (0\/34, 0%), and the incidence was 3.0% (1\/33) at 6\u2009months. The median MMSE score remained 29 from pre\u2010radiotherapy to the end of radiotherapy, and no significant decline in MMSE scores was observed at 3\u2010and 6\u2010month post\u2010radiotherapy compared with pre\u2010radiotherapy levels. Dosimetric evaluation confirmed acceptable target coverage, conformity, and homogeneity index. Collectively, hippocampal avoidance with bilateral D\n                    <jats:sub>40<\/jats:sub>\n                    \u2009&lt;\u200915\u2009Gy was associated with a low incidence of anxiety in NPC patients undergoing IMRT without compromising target dose or cognitive function, providing a novel approach to improve quality of life.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70631","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:01:04Z","timestamp":1785128464000},"page":"2804-2812","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Hippocampal Avoidance on Anxiety in Patients With Nasopharyngeal Carcinoma Undergoing Intensity\u2010Modulated Radiotherapy: A Single\u2010Center, Single\u2010Arm, Prospective Clinical Trial"],"prefix":"10.1002","volume":"159","author":[{"given":"Xiujuan","family":"Gai","sequence":"first","affiliation":[{"name":"Department of Radiotherapy, Cancer Center The First Affiliated Hospital, Fujian Medical University  Fuzhou China"},{"name":"Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan China"},{"name":"Department of Oncology Laiyang Central Hospital of Yantai  Yantai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiqi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Cancer Center The First Affiliated Hospital, Fujian Medical University  Fuzhou China"},{"name":"Key Laboratory of Radiation Biology of Fujian Higher Education Institutions The First Affiliated Hospital, Fujian Medical University  Fuzhou China"},{"name":"Department of Radiotherapy, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital Fujian Medical University  Fuzhou 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