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The median SUV\n                      <jats:sub>max<\/jats:sub>\n                      was 6.96, and the Dice similarity coefficient ranged from 0.707 to 0.723. CXCR4\u2010avid sub\u2010volumes within GTV were characterized against the sub\u2010targets of stereotactic body radiotherapy based partial tumor irradiation targeting hypoxic segments (SBRT\u2010PATHY) and stereotactic centralized ablative radiation therapy (SCART). Dosimetric comparisons were performed between the BG\u2010pSFRT and SCART plans (15\u201324 Gy per fraction in three fractions).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CXCR4\u2010defined sub\u2010volumes with low thresholds in BG\u2010pSFRT demonstrated spatial concordance with putative hypoxic sub\u2010volumes in SBRT\u2010PATHY, whereas higher SUV\n                      <jats:sub>max<\/jats:sub>\n                      thresholds yielded multifocal distributions that exhibited spatial discordance relative to SCART, and these multifocal imaging\u2010defined sub\u2010volumes were targeted in BG\u2010pSFRT for dose escalation. Compared to proton SCART, BG\u2010pSFRT achieved greater high\u2010dose (V\n                      <jats:sub>80%<\/jats:sub>\n                      ), GTV coverage but slightly lower sub\u2010volume conformity (89.04% vs. 95.55%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001), and higher V\n                      <jats:sub>5Gy<\/jats:sub>\n                      and dose per fraction (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001). All organ\u2010at\u2010risk doses met the standard 3\u2010fraction SBRT constraints.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CXCR4\u2010targeted BG\u2010pSFRT may be a dosimetrically feasible strategy for bulky limited\u2010stage small cell lung cancer and demonstrates distinct dosimetric characteristics. The current research findings are limited to the dosimetric level and further clinical trials are required for verification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pro6.70095","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T09:41:43Z","timestamp":1789206103000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["C\u2013X\u2013C Motif Chemokine Receptor 4 (CXCR4)\u2010Targeted Biologically Guided Proton Spatially Fractionated Radiotherapy for Bulky Limited\u2010Stage Small Cell Lung Cancer"],"prefix":"10.1002","author":[{"given":"Keru","family":"Pu","sequence":"first","affiliation":[{"name":"Shandong Provincial Key Laboratory of Precision Oncology Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan  Shandong 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