{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T14:27:43Z","timestamp":1792679263365,"version":"4.5.0"},"reference-count":27,"publisher":"Elsevier BV","issue":"5","license":[{"start":{"date-parts":[[2017,12,1]],"date-time":"2017-12-01T00:00:00Z","timestamp":1512086400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["redjournal.org","clinicalkey.jp","clinicalkey.com","clinicalkey.es","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Radiation Oncology*Biology*Physics"],"published-print":{"date-parts":[[2017,12]]},"DOI":"10.1016\/j.ijrobp.2017.07.044","type":"journal-article","created":{"date-parts":[[2017,8,3]],"date-time":"2017-08-03T20:34:15Z","timestamp":1501792455000},"page":"1243-1252","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":32,"title":["Local Protocol Variations for Image Guided Radiation Therapy in the Multicenter Dutch Hypofractionation (HYPRO) Trial: Impact of Rectal Balloon and MRI Delineation on Anorectal Dose and Gastrointestinal Toxicity Levels"],"prefix":"10.1016","volume":"99","author":[{"given":"Ruud C.","family":"Wortel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilma D.","family":"Heemsbergen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Jan","family":"Smeenk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marnix G.","family":"Witte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stijn D.G.","family":"Krol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floris J.","family":"Pos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Incrocci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ijrobp.2017.07.044_bib1","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.ijrobp.2014.12.017","article-title":"Acute toxicity after image-guided intensity modulated radiation therapy compared to 3D conformal radiation therapy in prostate cancer patients","volume":"91","author":"Wortel","year":"2015","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib2","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/j.ijrobp.2016.01.031","article-title":"Late side effects after image\u00a0guided intensity modulated radiation therapy compared to 3D-conformal radiation therapy for prostate cancer: Results from 2 prospective cohorts","volume":"95","author":"Wortel","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib3","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/S1470-2045(14)70482-6","article-title":"Hypofractionated versus conventionally fractionated radiotherapy for patients with prostate cancer (HYPRO): Acute toxicity results from a randomised non-inferiority phase 3 trial","author":"Aluwini","year":"2015","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib4","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/S1470-2045(15)00567-7","article-title":"Hypofractionated versus conventionally fractionated radiotherapy for patients with prostate cancer (HYPRO): Late toxicity results from a randomised, non-inferiority, phase 3 trial","volume":"17","author":"Aluwini","year":"2016","journal-title":"Lancet Oncology"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib5","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/S1470-2045(16)30070-5","article-title":"Hypofractionated versus conventionally fractionated radiotherapy for patients with localised prostate cancer (HYPRO): final efficacy results from a randomised, multicentre, open-label, phase 3 trial","volume":"17","author":"Incrocci","year":"2016","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib6","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0167-8140(97)00232-6","article-title":"Magnetic resonance imaging (MRI) for localization of the prostatic apex: Comparison to computed tomography (CT) and urethrography","volume":"47","author":"Milosevic","year":"1998","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib7","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/S0360-3016(98)00351-4","article-title":"Definition of the prostate in CT and MRI: A multi-observer study","volume":"43","author":"Rasch","year":"1999","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib8","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.semradonc.2005.01.005","article-title":"Target definition in prostate, head, and neck","volume":"15","author":"Rasch","year":"2005","journal-title":"Semin Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib9","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1016\/j.ijrobp.2008.06.1491","article-title":"Changes in prostate shape and volume and their implications for radiotherapy after introduction of endorectal balloon as determined by MRI at 3T","volume":"73","author":"Heijmink","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib10","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1016\/j.ijrobp.2011.07.028","article-title":"An endorectal balloon reduces intrafraction prostate motion during radiotherapy","volume":"83","author":"Smeenk","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib11","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/j.ijrobp.2006.09.034","article-title":"Reduced late rectal mucosal changes after prostate three-dimensional conformal radiotherapy with endorectal balloon as observed in repeated endoscopy","volume":"67","author":"van Lin","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib12","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.ijrobp.2003.10.059","article-title":"A comparison of the single and double factor high-risk models for risk assignment of prostate cancer treated with 3D conformal radiotherapy","volume":"59","author":"Chism","year":"2004","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib13","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/S0090-4295(01)01441-8","article-title":"Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium","volume":"58","author":"Partin","year":"2001","journal-title":"Urology"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib14","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.radonc.2010.04.016","article-title":"Is there a role for endorectal balloons in prostate radiotherapy? A systematic review","volume":"95","author":"Smeenk","year":"2010","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib15","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ijrobp.2007.05.046","article-title":"Adaptive radiotherapy for prostate cancer using kilovoltage cone-beam computed tomography: First clinical results","volume":"70","author":"Nijkamp","year":"2008","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib16","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.radonc.2015.10.020","article-title":"Dose-surface maps identifying local dose-effects for acute gastrointestinal toxicity after radiotherapy for prostate cancer","volume":"117","author":"Wortel","year":"2015","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib17","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1007\/s00066-003-1029-9","article-title":"Acute side effects during 3-D-planned conformal radiotherapy of prostate cancer. Differences between patient's self-reported questionnaire and the\u00a0corresponding doctor's report","volume":"179","author":"Goldner","year":"2003","journal-title":"Strahlenther Onkol"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib18","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1001\/jama.1995.03520260051032","article-title":"Quality-of-life outcomes in men treated for localized prostate cancer","volume":"273","author":"Litwin","year":"1995","journal-title":"JAMA"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib19","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/j.ijrobp.2004.07.715","article-title":"Acute and late complications after radiotherapy for prostate cancer: Results of a multicenter randomized trial comparing 68 Gy to 78 Gy","volume":"61","author":"Peeters","year":"2005","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib20","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/0360-3016(95)00060-C","article-title":"Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC)","volume":"31","author":"Cox","year":"1995","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib21","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/0360-3016(96)00232-5","article-title":"Prostate volumes defined by magnetic resonance imaging and computerized tomographic scans for three-dimensional conformal radiotherapy","volume":"35","author":"Roach","year":"1996","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib22","doi-asserted-by":"crossref","first-page":"809","DOI":"10.3109\/0284186X.2013.865077","article-title":"MRI target delineation may reduce long-term toxicity after prostate radiotherapy","volume":"53","author":"Sander","year":"2014","journal-title":"Acta Oncol"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib23","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.radonc.2009.05.014","article-title":"Anal wall sparing effect of an endorectal balloon in 3D conformal and intensity-modulated prostate radiotherapy","volume":"93","author":"Smeenk","year":"2009","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib24","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/01.coc.0000195099.26957.63","article-title":"Tolerance of endorectal balloon in 396 patients treated with intensity-modulated radiation therapy (IMRT) for prostate cancer","volume":"29","author":"Bastasch","year":"2006","journal-title":"Am J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib25","doi-asserted-by":"crossref","first-page":"20140459","DOI":"10.1259\/bjr.20140459","article-title":"Image-guided radiotherapy of\u00a0the prostate using daily CBCT: The feasibility and likely benefit of\u00a0implementing a margin reduction","volume":"87","author":"Maund","year":"2014","journal-title":"Br J Radiol"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib26","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.radonc.2011.10.025","article-title":"Clinical impact of margin reduction on late toxicity and short-term biochemical control for patients treated with daily on-line image guided IMRT for prostate cancer","volume":"103","author":"Crehange","year":"2012","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2017.07.044_bib27","doi-asserted-by":"crossref","first-page":"S59","DOI":"10.1016\/j.juro.2012.11.032","article-title":"Differing perceptions of quality of life in patients with prostate cancer and their doctors","volume":"189","author":"Sonn","year":"2013","journal-title":"J Urol"}],"container-title":["International Journal of Radiation Oncology*Biology*Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0360301617336908?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0360301617336908?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2018,8,29]],"date-time":"2018-08-29T19:50:40Z","timestamp":1535572240000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0360301617336908"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,12]]}},"alternative-id":["S0360301617336908"],"URL":"https:\/\/doi.org\/10.1016\/j.ijrobp.2017.07.044","relation":{},"ISSN":["0360-3016"],"issn-type":[{"value":"0360-3016","type":"print"}],"subject":[],"published":{"date-parts":[[2017,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Local Protocol Variations for Image Guided Radiation Therapy in the Multicenter Dutch Hypofractionation (HYPRO) Trial: Impact of Rectal Balloon and MRI Delineation on Anorectal Dose and Gastrointestinal Toxicity Levels","name":"articletitle","label":"Article Title"},{"value":"International Journal of Radiation Oncology*Biology*Physics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ijrobp.2017.07.044","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2017 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}