{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:31:56Z","timestamp":1786386716957,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare cochlear dose and hearing outcomes between intensity\u2010modulated proton therapy (IMPT) and volumetric modulated arc therapy (VMAT) in patients with nasopharyngeal carcinoma (NPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective matched cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary academic center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 180 newly diagnosed, treatment\u2010naive NPC patients receiving definitive radiotherapy between 2023 and 2025 were enrolled. Patients were 1:1 matched by sex, age, and disease stage, and assigned to IMPT (n\u2009=\u200990) or VMAT (n\u2009=\u200990). Mean cochlear dose was recorded. Audiological evaluations, including pure\u2010tone audiometry (PTA), air\u2010bone gap, and word recognition score, were performed before and after treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      IMPT delivered significantly lower mean doses to the ipsilateral (47.51 vs 56.82\u2009Gy,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001; 95% CI: \u201314.27 to \u20134.35) and contralateral cochlea (30.79 vs 45.71\u2009Gy,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001; 95% CI: \u201318.93 to \u201310.91). Based on each patient's most recent audiometric assessment (median follow\u2010up, 12.1 months; range, 7.5\u201019.5 months), IMPT demonstrated better average PTA thresholds than VMAT (33.72 vs 42.00\u2009dB;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.016; 95% CI, \u201314.91 to \u20131.65), superior high\u2010frequency hearing at 2 to 8\u2009kHz (37.94 vs 53.82\u2009dB;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001; 95% CI, \u201323.69 to \u20138.07), lower air\u2010bone gap (5.67 vs 10.62\u2009dB;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001; 95% CI, \u20136.80 to \u20133.10), and higher word recognition scores (96.67% vs 94.00%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.039; 95% CI, 0.14\u20105.20), with less bone conduction loss at 1 to 4\u2009kHz.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IMPT reduces cochlear dose compared to VMAT, resulting in better hearing preservation and suggesting its potential to minimize ototoxicity in NPC patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70113","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T10:59:54Z","timestamp":1767869994000},"page":"450-457","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Auditory Preservation in Nasopharyngeal Carcinoma: Comparison of Proton and Photon Radiotherapy"],"prefix":"10.1002","volume":"174","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5986-2148","authenticated-orcid":false,"given":"Kuang\u2010Hsu","family":"Lien","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Linkou Chang Gung Memorial Hospital Taoyuan City 333423 Guishan District Taiwan"},{"name":"School of Traditional Chinese Medicine, College of Medicine Chang Gung University Taoyuan 333323 Taiwan"},{"name":"Graduate Institute of Clinical Medical Sciences, College of Medicine Chang Gung University Taoyuan 333323 Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Proton and Radiation Therapy Center Linkou Chang Gung Memorial Hospital Taoyuan City 333423 Guishan District Taiwan"},{"name":"Radiation Research Core Laboratory Chang Gung Memorial Hospital at Linkou Taoyuan City 333423 Guishan District Taiwan"},{"name":"College of Medicine Chang Gung University Taoyuan 333323 Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po\u2010Yuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Proton and Radiation Therapy Center Linkou Chang Gung Memorial Hospital Taoyuan City 333423 Guishan District Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph Tung\u2010Chieh","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Proton and Radiation Therapy Center Linkou Chang Gung Memorial Hospital Taoyuan City 333423 Guishan District Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tai\u2010Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Koo Foundation Sun Yat\u2010Sen Cancer Center Taipei 112019 Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng\u2010Ping","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Proton and Radiation Therapy Center Linkou Chang Gung Memorial Hospital Taoyuan City 333423 Guishan District Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching\u2010Hsin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Proton and Radiation Therapy Center Linkou Chang Gung Memorial Hospital Taoyuan City 333423 Guishan District Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing\u2010Keen","family":"Yap","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Proton and Radiation Therapy Center Linkou Chang Gung Memorial Hospital Taoyuan City 333423 Guishan District Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010En","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Proton and Radiation Therapy Center Linkou Chang Gung Memorial Hospital Taoyuan City 333423 Guishan District Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010Lung","family":"Hsu","sequence":"additional","affiliation":[{"name":"College of Medicine Chang Gung University Taoyuan 333323 Taiwan"},{"name":"Division of Hematology\u2010Oncology, Department of Internal Medicine Linkou Chang Gung Memorial Hospital Taoyuan City 333423 Guishan District Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi\u2010Yin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Linkou Chang Gung Memorial Hospital Taoyuan City 333423 Guishan District Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1777-9578","authenticated-orcid":false,"given":"Kai\u2010Ping","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Linkou Chang Gung Memorial Hospital Taoyuan City 333423 Guishan District Taiwan"},{"name":"College of Medicine Chang Gung University Taoyuan 333323 Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30956-0"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1701717"},{"key":"e_1_2_9_4_1","first-page":"421","volume-title":"Epidemiology of Nasopharyngeal Carcinoma","author":"Mimi CY","year":"2002"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2015.10.011"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.07.034"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-023-02268-7"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.21037\/anpc-20-16"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.06.013"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13143555"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014-020-01532-4"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12071060"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.21037\/cco.2016.03.05"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2004.05.010"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.19.9109"},{"key":"e_1_2_9_16_1","unstructured":"LeeNXP DimitriosCA.NRG\u2010HN001 Randomized Phase II and Phase III Studies of Individualized Treatment for Nasopharyngeal Carcinoma Based on Biomarker Epstein\u2010Barr Virus (EBV) Deoxyribonucleic Acid (DNA).https:\/\/www.nrgoncology.org\/Clinical-Trials\/Protocol\/nrg-hn001?filter=nrg-hn001"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14163853"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(91)90692-W"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2012.11.002"},{"key":"e_1_2_9_20_1","first-page":"59","article-title":"Auditory physiology","volume":"5","author":"Merchant SN","year":"2003","journal-title":"Surg Ear"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2021.10.013"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2021.02.001"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radi.2016.08.008"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-8140(02)00211-6"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2025.103877"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2003.07.008"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2008.01.050"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003313"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14010225"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/0300060519858031"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70113","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ohn.70113","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ohn.70113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:26:49Z","timestamp":1786386409000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1002\/ohn.70113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,8]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/ohn.70113"],"URL":"https:\/\/doi.org\/10.1002\/ohn.70113","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,8]]},"assertion":[{"value":"2025-07-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}