{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:57:52Z","timestamp":1789520272901,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["12575388"],"award-info":[{"award-number":["12575388"]}],"id":[{"id":"10.13039\/501100001809","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":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The development of FLASH radiotherapy has gained attention for its potential to deliver high doses in very short treatment times, minimizing damage to normal tissues.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study developed and evaluated FLASHPlan, a treatment planning system (TPS) for multi\u2010beam photon FLASH (XFLASH) therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>FLASHPlan integrates the Fractional Combination Radiotherapy (FCRT) strategy with voxel\u2010level biological correction, using an organ\u2010specific dose\u2010modifying factor model and biologically effective dose (BED)\u2010based summation, under ultra\u2010high dose rate constraints. FCRT distributes clinically required beam angles across multiple fractions, delivering fixed static beams per session with inter\u2010fractional gantry reconfiguration. Fifty stereotactic body radiotherapy cases (single\u2010target brain, multifocal brain, lung, pancreas, and concave\u2010type prostate; 45\u00a0Gy in 3 fractions) were retrospectively replanned using FCRT and compared with conventional five static\u2010beam plans (Conv_5F). Dose\u2010volume metrics were reported on a common equivalent\u2010dose scale, and a passing rate (PR) was defined as the percentage of cases meeting SBRT constraints. Sensitivity analyses varied organ\u2010specific \u03bb and the assumed FLASH plateau dose\u2010rate between 40 and 200\u00a0Gy\/s.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with Conv_5F, FCRT modestly increased mean gross tumor volume (GTV) V45Gy in all cohorts and raised PR for V45Gy \u2265 95% from 10%\u201380% to 100% (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). On DMF\u2010modified equivalent\u2010dose distributions, FCRT improved conformity index (CI) and reduced gradient index (GI) and high\u2010dose spillage in every cohort (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), indicating tighter high\u2010dose regions and steeper dose fall\u2010off. High\u2010dose exposure to critical CNS, thoracic, abdominal, and pelvic organs\u2010at\u2010risk (OARs) was reduced, with PR for the most restrictive OAR constraints reaching 100%, while Lyman\u2010Kutcher\u2010Burman\u2010based normal tissue complication probability estimates for lung and brainstem changed minimally and remained within clinically acceptable ranges. In all \u03bb and dose\u2010rate sensitivity scenarios, cohort\u2010averaged FCRT OAR doses varied only modestly and the dosimetric advantage of FCRT over Conv_5F was preserved.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FLASHPlan establishes a proof\u2010of\u2010concept TPS framework for multi\u2010beam XFLASH by combining geometry\u2010aware FCRT delivery with biology\u2010aware DMF\/BED dose evaluation. Rather than demonstrating therapeutic superiority of FLASH\u2010RT, this work provides a planning infrastructure to support future XFLASH system development, radiobiological modeling, and clinical translation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.70331","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T15:26:48Z","timestamp":1770737208000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a proof\u2010of\u2010concept treatment planning system for multi\u2010beam photon FLASH intensity modulated radiation therapy"],"prefix":"10.1002","volume":"53","author":[{"given":"Guo","family":"Chenlei","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cui","family":"Weijie","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zha","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Engineering Physics Tsinghua University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhu","family":"Meng","sequence":"additional","affiliation":[{"name":"Homology Medical Technologies Inc.  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Jin","sequence":"additional","affiliation":[{"name":"Homology Medical Technologies Inc.  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang","family":"He","sequence":"additional","affiliation":[{"name":"Homology Medical Technologies Inc.  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang","family":"Weiping","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":"Zhu","family":"Hongyu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Sun Yat\u2010sen University Cancer Center State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhou","family":"Yin","sequence":"additional","affiliation":[{"name":"Homology Medical Technologies Inc.  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