{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T14:33:34Z","timestamp":1775486014871,"version":"3.50.1"},"reference-count":53,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01CA261964"],"award-info":[{"award-number":["R01CA261964"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R37CA250921"],"award-info":[{"award-number":["R37CA250921"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Particle Therapy"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1016\/j.ijpt.2026.101302","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T16:07:18Z","timestamp":1769875638000},"page":"101302","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Spread-Out Bragg Peak FLASH Radiotherapy for Head and Neck Reirradiation: A Treatment Planning Study"],"prefix":"10.1016","volume":"19","author":[{"given":"Marc","family":"Alomar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnaud","family":"Pin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rasmus","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Traneus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory N.","family":"Gan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7771-0050","authenticated-orcid":false,"given":"Yuting","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"issue":"3","key":"10.1016\/j.ijpt.2026.101302_bib1","article-title":"FLASH: new intersection of physics, chemistry, biology, and cancer medicine","volume":"96","author":"Vozenin","year":"2024","journal-title":"Rev\u00a0Modern Phys"},{"issue":"245","key":"10.1016\/j.ijpt.2026.101302_bib2","first-page":"245ra293","article-title":"Ultrahigh dose-rate FLASH irradiation increases the differential response between normal and tumor tissue in mice","volume":"6","author":"Favaudon","year":"2014","journal-title":"Sci\u00a0Transl\u00a0Med"},{"issue":"3","key":"10.1016\/j.ijpt.2026.101302_bib3","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.radonc.2017.05.003","article-title":"Irradiation in a flash: unique sparing of memory in mice after whole brain irradiation with dose rates above 100Gy\/s","volume":"124","author":"Montay-Gruel","year":"2017","journal-title":"Radiother Oncol\u00a0J\u00a0Eur\u00a0Soc\u00a0Ther Radiol\u00a0Oncol"},{"issue":"1","key":"10.1016\/j.ijpt.2026.101302_bib4","first-page":"35","article-title":"The advantage of FLASH radiotherapy confirmed in mini-pig and cat-cancer patients","volume":"25","author":"Vozenin","year":"2019","journal-title":"Clin\u00a0Cancer Res"},{"issue":"16","key":"10.1016\/j.ijpt.2026.101302_bib5","doi-asserted-by":"crossref","first-page":"4244","DOI":"10.3390\/cancers13164244","article-title":"Comparison of FLASH proton entrance and the spread-out bragg peak dose regions in the sparing of mouse intestinal crypts and in a pancreatic tumor model","volume":"13","author":"Kim","year":"2021","journal-title":"Cancers"},{"issue":"6","key":"10.1016\/j.ijpt.2026.101302_bib6","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1158\/1535-7163.MCT-23-0663","article-title":"Proton FLASH radiotherapy ameliorates radiation-induced salivary gland dysfunction and oral mucositis and increases survival in a mouse model of head and neck cancer","volume":"23","author":"Chowdhury","year":"2024","journal-title":"Mol\u00a0Cancer Ther"},{"key":"10.1016\/j.ijpt.2026.101302_bib7","first-page":"109953","article-title":"Dosimetric and biologic intercomparison between electron and proton FLASH beams","volume":"190","author":"Almeida","year":"2024","journal-title":"Radiother\u00a0Oncol"},{"issue":"3","key":"10.1016\/j.ijpt.2026.101302_bib8","first-page":"582","article-title":"X-rays can trigger the FLASH effect: ultra-high dose-rate synchrotron light source prevents normal brain injury after whole brain irradiation in mice","volume":"129","author":"Montay-Gruel","year":"2018","journal-title":"Radiother\u00a0Oncol"},{"issue":"7","key":"10.1016\/j.ijpt.2026.101302_bib9","first-page":"4875","article-title":"Ultra-high dose rate radiation production and delivery systems intended for FLASH","volume":"49","author":"Farr","year":"2022","journal-title":"Med\u00a0Phys"},{"issue":"1","key":"10.1016\/j.ijpt.2026.101302_bib10","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1001\/jamaoncol.2022.5843","article-title":"Proton FLASH radiotherapy for the treatment of symptomatic bone metastases: the FAST-01 nonrandomized trial","volume":"9","author":"Mascia","year":"2023","journal-title":"JAMA Oncol"},{"key":"10.1016\/j.ijpt.2026.101302_bib11","first-page":"71","article-title":"Technical challenges for FLASH proton therapy","volume":"78","author":"Jolly","year":"2020","journal-title":"Phys\u00a0Med\u00a0Eur\u00a0J\u00a0Med\u00a0Phys"},{"issue":"5","key":"10.1016\/j.ijpt.2026.101302_bib12","first-page":"1202","article-title":"Framework for quality assurance of ultrahigh dose rate clinical trials investigating FLASH effects and current technology gaps","volume":"116","author":"Zou","year":"2023","journal-title":"Int\u00a0J\u00a0Radiat\u00a0Oncol\u00a0Biol\u00a0Phys"},{"issue":"3","key":"10.1016\/j.ijpt.2026.101302_bib13","first-page":"351","article-title":"Navigating the critical translational questions for implementing FLASH in the clinic","volume":"34","author":"Loo","year":"2024","journal-title":"Semin\u00a0Radiat\u00a0Oncol"},{"issue":"17","key":"10.1016\/j.ijpt.2026.101302_bib14","first-page":"7075","article-title":"3D range-modulator for scanned particle therapy: development, Monte Carlo simulations and experimental evaluation","volume":"62","author":"Simeonov","year":"2017","journal-title":"Phys\u00a0Med\u00a0Biol"},{"issue":"1","key":"10.1016\/j.ijpt.2026.101302_bib15","first-page":"203","article-title":"A universal range shifter and range compensator can enable proton pencil beam scanning single-energy bragg peak FLASH-RT treatment using current commercially available proton systems","volume":"113","author":"Kang","year":"2022","journal-title":"Int\u00a0J\u00a0Radiat\u00a0Oncol\u00a0Biol\u00a0Phys"},{"issue":"4","key":"10.1016\/j.ijpt.2026.101302_bib16","first-page":"2955","article-title":"Streamlined pin-ridge-filter design for single-energy proton FLASH planning","volume":"51","author":"Ma","year":"2024","journal-title":"Med\u00a0Phys"},{"issue":"22","key":"10.1016\/j.ijpt.2026.101302_bib17","doi-asserted-by":"crossref","first-page":"5790","DOI":"10.3390\/cancers13225790","article-title":"A novel proton pencil beam scanning FLASH RT delivery method enables optimal OAR sparing and ultra-high dose rate delivery: a comprehensive dosimetry study for lung tumors","volume":"13","author":"Wei","year":"2021","journal-title":"Cancers"},{"key":"10.1016\/j.ijpt.2026.101302_bib18","first-page":"2861","article-title":"Treatment planning for flash radiotherapy: general aspects and applications to proton beams","volume":"49","author":"Schwarz","year":"2022","journal-title":"Med\u00a0Phys"},{"issue":"15","key":"10.1016\/j.ijpt.2026.101302_bib19","doi-asserted-by":"crossref","first-page":"3828","DOI":"10.3390\/cancers15153828","article-title":"Proton Bragg peak FLASH enables organ sparing and ultra-high dose-rate delivery: proof of principle in recurrent head and neck cancer","volume":"15","author":"Pennock","year":"2023","journal-title":"Cancers"},{"key":"10.1016\/j.ijpt.2026.101302_bib20","first-page":"1369065","article-title":"Feasibility and constraints of Bragg peak FLASH proton therapy treatment planning","volume":"14","author":"L\u00f6vgren","year":"2024","journal-title":"Front\u00a0Oncol"},{"issue":"1","key":"10.1016\/j.ijpt.2026.101302_bib21","first-page":"253","article-title":"Impact of multiple beams on the FLASH effect in soft tissue and skin in mice","volume":"118","author":"Mascia","year":"2024","journal-title":"Int\u00a0J\u00a0Radiat\u00a0Oncol\u00a0Biol\u00a0Phys"},{"issue":"1","key":"10.1016\/j.ijpt.2026.101302_bib22","first-page":"265","article-title":"Proton FLASH: impact of dose rate and split dose on acute skin toxicity in a murine model","volume":"120","author":"S\u00f8rensen","year":"2024","journal-title":"Int\u00a0J\u00a0Radiat\u00a0Oncol\u00a0Biol\u00a0Phys"},{"issue":"6","key":"10.1016\/j.ijpt.2026.101302_bib23","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1002\/hed.24733","article-title":"Reirradiation of head and neck cancer: long-term disease control and toxicity","volume":"39","author":"Bots","year":"2017","journal-title":"Head Neck"},{"issue":"1","key":"10.1016\/j.ijpt.2026.101302_bib24","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.50607","article-title":"Evaluation of proton therapy reirradiation for patients with recurrent head and neck squamous cell carcinoma","volume":"6","author":"Lee","year":"2023","journal-title":"JAMA Network Open"},{"issue":"1","key":"10.1016\/j.ijpt.2026.101302_bib25","first-page":"137","article-title":"Head and neck tumor control probability: radiation dose\u2013volume effects in stereotactic body radiation therapy for locally recurrent previously-irradiated head and neck cancer: report of the AAPM Working Group","volume":"110","author":"Vargo","year":"2021","journal-title":"Int\u00a0J\u00a0Radiat\u00a0Oncol\u00a0Biol\u00a0Phys"},{"issue":"11","key":"10.1016\/j.ijpt.2026.101302_bib26","doi-asserted-by":"crossref","first-page":"3331","DOI":"10.1002\/hed.26820","article-title":"Stereotactic body ablative radiotherapy for reirradiation of small volume head and neck cancers is associated with prolonged survival: large, single-institution, modern cohort study","volume":"43","author":"Diao","year":"2021","journal-title":"Head Neck"},{"issue":"3","key":"10.1016\/j.ijpt.2026.101302_bib27","first-page":"2026","article-title":"A quantitative FLASH effectiveness model to reveal potentials and pitfalls of high dose rate proton therapy","volume":"49","author":"Krieger","year":"2022","journal-title":"Med\u00a0Phys"},{"key":"10.1016\/j.ijpt.2026.101302_bib28","article-title":"P143 \/ #491-Commissioning and QA of a flash-capable SNOUT","volume":"12","author":"Diffenderfer","year":"2024","journal-title":"Int\u00a0J\u00a0Part\u00a0Ther"},{"key":"10.1016\/j.ijpt.2026.101302_bib29","unstructured":"Deffet S, Souris K, Sterpin E. Optimization of patient-specific range modulators for conformal FLASH proton therapy. 2023; arXiv:2303.08649."},{"key":"10.1016\/j.ijpt.2026.101302_bib30","first-page":"S66","article-title":"Pencil beam proton flash therapy, field size limit with conformalflash","volume":"94","author":"Pin","year":"2022","journal-title":"Phys\u00a0Med"},{"issue":"7","key":"10.1016\/j.ijpt.2026.101302_bib31","first-page":"5081","article-title":"Secondary neutron dosimetry for conformal FLASH proton therapy","volume":"51","author":"Chen","year":"2024","journal-title":"Med\u00a0Phys"},{"issue":"8","key":"10.1016\/j.ijpt.2026.101302_bib32","first-page":"4078","article-title":"Stereotactic body radiation therapy: the report of AAPM Task Group 101","volume":"37","author":"Benedict","year":"2010","journal-title":"Med\u00a0Phys"},{"issue":"1","key":"10.1016\/j.ijpt.2026.101302_bib33","article-title":"Prescribing, recording, and reporting photon\u2011beam intensity\u2011modulated radiation therapy (IMRT): ICRU report 83","volume":"10","year":"2010","journal-title":"J ICRU"},{"issue":"9","key":"10.1016\/j.ijpt.2026.101302_bib34","first-page":"5784","article-title":"Definition of dose rate for FLASH pencil-beam scanning proton therapy: a comparative study","volume":"50","author":"Deffet","year":"2023","journal-title":"Med\u00a0Phys"},{"issue":"12","key":"10.1016\/j.ijpt.2026.101302_bib35","first-page":"6396","article-title":"A framework for defining FLASH dose rate for pencil beam scanning","volume":"47","author":"Folkerts","year":"2020","journal-title":"Med\u00a0Phys"},{"issue":"1","key":"10.1016\/j.ijpt.2026.101302_bib36","first-page":"01NT01","article-title":"Building a precise machine-specific time structure of the spot and energy delivery model for a cyclotron-based proton therapy system","volume":"67","author":"Zhao","year":"2022","journal-title":"Phys\u00a0Med\u00a0Biol"},{"key":"10.1016\/j.ijpt.2026.101302_bib37","first-page":"212","article-title":"Current delivery limitations of proton PBS for FLASH","volume":"155","author":"Zou","year":"2021","journal-title":"Radiother\u00a0Oncol"},{"issue":"5","key":"10.1016\/j.ijpt.2026.101302_bib38","first-page":"1032","article-title":"Normal tissue sparing by FLASH as a function of single-fraction dose: a quantitative analysis","volume":"114","author":"B\u00f6hlen","year":"2022","journal-title":"Int\u00a0J\u00a0Radiat\u00a0Oncol\u00a0Biol\u00a0Phys"},{"issue":"3","key":"10.1016\/j.ijpt.2026.101302_bib39","first-page":"1335","article-title":"Impact of range shifter material on proton pencil beam spot characteristics","volume":"42","author":"Shen","year":"2015","journal-title":"Med\u00a0Phys"},{"key":"10.1016\/j.ijpt.2026.101302_bib40","article-title":"Clinical implementation of proton therapy using pencil-beam scanning delivery combined with static apertures","volume":"11","author":"B\u00e4umer","year":"2021","journal-title":"Front\u00a0Oncol"},{"key":"10.1016\/j.ijpt.2026.101302_bib41","first-page":"109","article-title":"In vivo validation and tissue sparing factor for acute damage of pencil beam scanning proton FLASH","volume":"167","author":"Singers S\u00f8rensen","year":"2022","journal-title":"Radiother\u00a0Oncol"},{"issue":"3","key":"10.1016\/j.ijpt.2026.101302_bib42","first-page":"2014","article-title":"Simultaneous dose and dose rate optimization (SDDRO) of the FLASH effect for pencil-beam-scanning proton therapy","volume":"49","author":"Gao","year":"2022","journal-title":"Med\u00a0Phys"},{"key":"10.1016\/j.ijpt.2026.101302_bib43","unstructured":"Applications IB. Ion Beam Applications. http:\/\/www.open\ufb02ash.software."},{"issue":"8","key":"10.1016\/j.ijpt.2026.101302_bib44","first-page":"5190","article-title":"Simultaneous dose and dose rate optimization via dose modifying factor modeling for FLASH effective dose","volume":"51","author":"Ma","year":"2024","journal-title":"Med\u00a0Phys"},{"issue":"12","key":"10.1016\/j.ijpt.2026.101302_bib45","first-page":"6388","article-title":"Simultaneous dose and dose rate optimization (SDDRO) for FLASH proton therapy","volume":"47","author":"Gao","year":"2020","journal-title":"Med\u00a0Phys"},{"issue":"12","key":"10.1016\/j.ijpt.2026.101302_bib46","article-title":"SDDRO-joint: simultaneous dose and dose rate optimization with the joint use of transmission beams and Bragg peaks for FLASH proton therapy","volume":"66","author":"Lin","year":"2021","journal-title":"Phys\u00a0Med\u00a0Biol"},{"issue":"12","key":"10.1016\/j.ijpt.2026.101302_bib47","first-page":"7826","article-title":"Dose and dose rate objectives in Bragg peak and shoot-through beam orientation optimization for FLASH proton therapy","volume":"49","author":"Ramesh","year":"2022","journal-title":"Med\u00a0Phys"},{"issue":"2","key":"10.1016\/j.ijpt.2026.101302_bib48","first-page":"440","article-title":"Design, implementation, and in vivo validation of a novel proton FLASH radiation therapy system","volume":"106","author":"Diffenderfer","year":"2020","journal-title":"Int\u00a0J\u00a0Radiat\u00a0Oncol\u00a0Biol\u00a0Phys"},{"issue":"10","key":"10.1016\/j.ijpt.2026.101302_bib49","doi-asserted-by":"crossref","first-page":"3022","DOI":"10.3390\/cancers12103022","article-title":"Carbon ion radiobiology","volume":"12","author":"Tinganelli","year":"2020","journal-title":"Cancers"},{"key":"10.1016\/j.ijpt.2026.101302_bib50","first-page":"11","article-title":"Clinical translation of FLASH radiotherapy: Why and how?","volume":"139","author":"Bourhis","year":"2019","journal-title":"Radiother\u00a0Oncol"},{"issue":"3","key":"10.1016\/j.ijpt.2026.101302_bib51","first-page":"256","article-title":"Relative biological effectiveness uncertainties and implications for beam arrangements and dose constraints in proton therapy","volume":"28","author":"Paganetti","year":"2018","journal-title":"Semin\u00a0Radiat\u00a0Oncol"},{"issue":"22","key":"10.1016\/j.ijpt.2026.101302_bib52","first-page":"R419","article-title":"Relative biological effectiveness (RBE) values for proton beam therapy. Variations as a function of biological endpoint, dose, and linear energy transfer","volume":"59","author":"Paganetti","year":"2014","journal-title":"Phys\u00a0Med\u00a0Biol"},{"issue":"1","key":"10.1016\/j.ijpt.2026.101302_bib53","first-page":"202","article-title":"NRG oncology white paper on the relative biological effectiveness in proton therapy","volume":"121","author":"Paganetti","year":"2025","journal-title":"Int\u00a0J\u00a0Radiat\u00a0Oncol\u00a0Biol\u00a0Phys"}],"container-title":["International Journal of Particle Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2331518026000053?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2331518026000053?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T13:41:38Z","timestamp":1775482898000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2331518026000053"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":53,"alternative-id":["S2331518026000053"],"URL":"https:\/\/doi.org\/10.1016\/j.ijpt.2026.101302","relation":{},"ISSN":["2331-5180"],"issn-type":[{"value":"2331-5180","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Spread-Out Bragg Peak FLASH Radiotherapy for Head and Neck Reirradiation: A Treatment Planning Study","name":"articletitle","label":"Article Title"},{"value":"International Journal of Particle Therapy","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ijpt.2026.101302","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Published by Elsevier B.V. on behalf of Particle Therapy Co-operative Group.","name":"copyright","label":"Copyright"}],"article-number":"101302"}}