{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:04:38Z","timestamp":1788350678909,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:00:00Z","timestamp":1672272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002855","name":"Ministry of Science and Technology of the People's Republic of China","doi-asserted-by":"publisher","award":["2016YFC0105207"],"award-info":[{"award-number":["2016YFC0105207"]}],"id":[{"id":"10.13039\/501100002855","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Treatment of locally advanced pancreatic cancer (LAPC) has long been calling for advances in technology of radiotherapy. Patients who received radiotherapy still had high risks of local recurrence, while suffering from gastrointestinal side effects. Based on the inherent characteristics of the x\u2010ray and \u03b3\u2010Ray radiation techniques, here we proposed and investigated an unexplored radiation therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the potential clinical benefit of a novel x\u2010ray and \u03b3\u2010Ray combination radiation technique in patients with LAPC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective intensity\u2010modulated radiotherapy (IMRT) treatment plans of 10 LAPC patients were randomly selected to compare with dual\u2010modality plans. The prescribed dose to PGTV was 60.2\u00a0Gy. The PGTV dose was further escalated in dual\u2010modality plan while maintaining clinically tolerable dose to organs at risk (OARs). Dosimetric comparisons were made and analyzed for three treatment plans (tomotherapy, standard dual\u2010modality plan, escalated dual\u2010modality plan) to assess the ability to increase dose to target volume while minimizing dose in adjacent OARs. Finally, radiobiological models were utilized for comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All strategies resulted in dosimetrically acceptable plans. Dual\u2010modality plans were present with similar conformity index (CI) and significantly lower gradient index (GI) compared with tomotherapy (3.64\u00a0\u00b1\u00a00.37\u00a0vs. 4.14\u00a0\u00b1\u00a00.61, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002; 3.64\u00a0\u00b1\u00a00.42\u00a0vs. 4.14\u00a0\u00b1\u00a00.61, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.003). D<jats:sub>mean<\/jats:sub> of PGTV (65.46\u00a0\u00b1\u00a03.13\u00a0vs. 61.56\u00a0\u00b1\u00a01.00, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.009; 77.98\u00a0\u00b1\u00a05.86\u00a0vs. 61.56\u00a0\u00b1\u00a01.00, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001) and PCTV (55.04\u00a0\u00b1\u00a02.14\u00a0vs. 53.93\u00a0\u00b1\u00a01.67, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.016; 58.24\u00a0\u00b1\u00a03.24\u00a0vs. 53.93\u00a0\u00b1\u00a01.67, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) were significantly higher, while D<jats:sub>mean<\/jats:sub> of the stomach was reduced in both dual\u2010modality plans (17.98\u00a0\u00b1\u00a010.23\u00a0vs. 19.34\u00a0\u00b1\u00a09.75, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.024; 17.62\u00a0\u00b1\u00a09.92\u00a0vs. 19.34\u00a0\u00b1\u00a09.75, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.040). The lower V<jats:sub>30Gy<\/jats:sub> in the liver (4.83\u00a0\u00b1\u00a05.87\u00a0vs. 6.23\u00a0\u00b1\u00a06.68, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.015; 4.90\u00a0\u00b1\u00a05.93\u00a0vs. 6.23\u00a0\u00b1\u00a06.68, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.016) and lower V<jats:sub>45Gy<\/jats:sub> of the small intestine (3.35\u00a0\u00b1\u00a03.30\u00a0vs. 4.06\u00a0\u00b1\u00a03.87, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.052) were found in dual\u2010modality plans. Meanwhile, radiobiological models demonstrated higher probability of tumor control (29.27%\u00a0\u00b1\u00a09.61% vs. 18.34%\u00a0\u00b1\u00a04.70%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001; 44.67%\u00a0\u00b1\u00a018.16% vs. 18.34%\u00a0\u00b1\u00a04.70%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) and lower probability of small intestine complication (2.16%\u00a0\u00b1\u00a02.30% vs. 1.25%\u00a0\u00b1\u00a02.72%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.048) in favor of dual\u2010modality strategy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A novel dual\u2010modality strategy of x\u2010ray and \u03b3\u2010Ray combination radiation appears reliable for target dose escalation and normal tissue dose reduction. This strategy might be beneficial for local tumor control and the protection of normal organs in patients with LAPC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16142","type":"journal-article","created":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T14:25:05Z","timestamp":1669991105000},"page":"1855-1864","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A novel X\u2010Ray and \u03b3\u2010Ray combination strategy for potential dose escalation in patients with locally advanced pancreatic cancer"],"prefix":"10.1002","volume":"50","author":[{"given":"Xia","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinjie","family":"Tao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingtian","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenbo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siqi","family":"Feng","sequence":"additional","affiliation":[{"name":"Our United Corporation  Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renqing","family":"Liu","sequence":"additional","affiliation":[{"name":"Our United Corporation  Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinsheng","family":"Li","sequence":"additional","affiliation":[{"name":"Our United Corporation  Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhikai","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2021.02.008"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2017.04.010"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014\u2010018\u20101158\u2010z"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1758835920977155"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2008.12.015"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.12.003"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12071729"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jrr\/rrw016"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2009.03.003"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2017.02.004"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.04.013"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2018.00618"},{"key":"e_1_2_11_14_1","first-page":"1139","article-title":"The application of gamma stereotactic body radiation therapy in stage I\/II non\u2010small\u2010cell lung cancer. 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