{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:41:37Z","timestamp":1792737697499,"version":"4.5.0"},"reference-count":75,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","redjournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Radiation Oncology*Biology*Physics"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.ijrobp.2026.08.017","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:51:16Z","timestamp":1787122276000},"page":"1145-1157","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Proton Radiation for Locally Advanced Breast Cancer: Evolution and Techniques"],"prefix":"10.1016","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9092-1337","authenticated-orcid":false,"given":"Shannon M.","family":"MacDonald","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youlia","family":"Kirova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linnae","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Jimenez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Artz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Depauw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myrsini","family":"Ioakeim-Ioannidou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Pankuch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Loap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardi","family":"Maria Cristina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert W.","family":"Mutter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean L.","family":"Wright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Isabelle","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ijrobp.2026.08.017_bib0001","doi-asserted-by":"crossref","first-page":"2869","DOI":"10.3390\/curroncol30030219","article-title":"The potential of proton therapy for locally advanced breast cancer: Clinical and technical considerations","volume":"30","author":"Lalani","year":"2023","journal-title":"Curr Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0002","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.ijrobp.2013.01.038","article-title":"Proton therapy for breast cancer after mastectomy: Early outcomes of a prospective clinical trial","volume":"86","author":"MacDonald","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0003","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.ijrobp.2021.05.110","article-title":"Proton therapy for breast cancer: A consensus statement from the Particle Therapy Cooperative Group Breast Cancer Subcommittee","volume":"111","author":"Mutter","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0004","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ctrv.2017.11.006","article-title":"Proton therapy for locally advanced breast cancer: A systematic review of the literature","volume":"63","author":"Kammerer","year":"2018","journal-title":"Cancer Treat Rev."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0005","doi-asserted-by":"crossref","DOI":"10.1177\/15330338241234788","article-title":"Proton therapy in breast cancer: A review of potential approaches for patient selection","volume":"23","author":"Wu","year":"2024","journal-title":"Technol Cancer Res Treat."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0006","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1056\/NEJMoa1209825","article-title":"Risk of ischemic heart disease in women after radiotherapy for breast cancer","volume":"368","author":"Darby","year":"2013","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0007","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1200\/JCO.2016.69.8480","article-title":"Validation and modification of a prediction model for acute cardiac events in patients with breast cancer treated with radiotherapy based on three-dimensional dose distributions to cardiac substructures","volume":"35","author":"van den Bogaard","year":"2017","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0008","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1200\/JCO.2011.34.5900","article-title":"Distribution of coronary artery stenosis after radiation for breast cancer","volume":"30","author":"Nilsson","year":"2012","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0009","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.ijrobp.2015.11.035","article-title":"Proton therapy for breast cancer: Getting to the heart of the matter","volume":"95","author":"MacDonald","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0010","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1080\/0284186X.2021.1957499","article-title":"Target coverage and cardiopulmonary sparing with the updated ESTRO-ACROP contouring guidelines for postmastectomy radiation therapy after breast reconstruction: A treatment planning study using VMAT and proton PBS techniques","volume":"60","author":"Milligan","year":"2021","journal-title":"Acta Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0011","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.radonc.2014.05.004","article-title":"Risk of second primary lung cancer in women after radiotherapy for breast cancer","volume":"111","author":"Grantzau","year":"2014","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0012","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/j.ijrobp.2023.02.023","article-title":"Proton beam therapy for early breast cancer: A systematic review and meta-analysis of clinical outcomes","volume":"117","author":"Holt","year":"2023","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0013","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1016\/j.ijrobp.2007.05.034","article-title":"Cardiac exposures in breast cancer radiotherapy: 1950s-1990s","volume":"69","author":"Taylor","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"10","key":"10.1016\/j.ijrobp.2026.08.017_bib0014","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-025556","article-title":"Pragmatic randomised clinical trial of proton versus photon therapy for patients with non-metastatic breast cancer: the Radiotherapy Comparative Effectiveness (RadComp) Consortium trial protocol","volume":"9","author":"Bekelman","year":"2019","journal-title":"BMJ Open"},{"issue":"4","key":"10.1016\/j.ijrobp.2026.08.017_bib0015","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijrobp.2025.08.025","article-title":"Phase III randomized trial of proton vs. photon therapy for patients with non-metastatic breast cancer receiving comprehensive nodal radiation: A Radiotherapy Comparative Effectiveness (Radcomp) Consortium Trial: Health-related quality of life outcomes","volume":"123","author":"MacDonald","year":"2025","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0016","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijrobp.2026.06.3055","article-title":"Associations between cardiac radiation dose-volume metrics and health-related quality of life for patients with breast cancer on the RadComp trial","author":"Wright","year":"2026","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0017","doi-asserted-by":"crossref","first-page":"14","DOI":"10.14338\/IJPT-20-00078.1","article-title":"A review of the robust optimization process and advances with Monte Carlo in the proton therapy management of head and neck tumors","volume":"8","author":"Zhang","year":"2021","journal-title":"Int J Part Ther"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0018","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijrobp.2026.05.052","article-title":"Comparative analysis of acute skin reactions after postmastectomy photon and intensity modulated proton therapy","author":"Gergelis","year":"2026","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0019","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.semradonc.2012.11.009","article-title":"Clinical controversies: Proton therapy for prostate cancer","volume":"23","author":"Mouw","year":"2013","journal-title":"Semin Radiat Oncol."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0020","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1001\/jama.1979.03290440034024","article-title":"Proton radiation as boost therapy for localized prostatic carcinoma","volume":"241","author":"Shipley","year":"1979","journal-title":"JAMA."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0021","doi-asserted-by":"crossref","unstructured":"White J, Tai A, Arthur D, Buchholz T, Macdonald S, Marks L, et al. Breast Cancer Atlas for Radiation Therapy Planning: Consensus Definitions Collaborators. Breast Cancer Atlas for Radiation Therapy Planning 2009;73:944\u2013951. https:\/\/www.rtog.org.","DOI":"10.1016\/j.ijrobp.2008.10.034"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0022","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.prro.2019.11.010","article-title":"Optimal target delineation and treatment techniques in the era of conformal photon and proton breast and regional nodal irradiation","volume":"10","author":"Kowalski","year":"2020","journal-title":"Pract Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0023","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.prro.2011.10.001","article-title":"Current clinical coverage of Radiation Therapy Oncology Group-defined target volumes for postmastectomy radiation therapy","volume":"2","author":"Fontanilla","year":"2012","journal-title":"Pract Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0024","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.radonc.2021.10.010","article-title":"Proton reirradiation for recurrent or new primary breast cancer in the setting of prior breast irradiation","volume":"165","author":"Choi","year":"2021","journal-title":"Radiother Oncol."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0025","first-page":"71","article-title":"Outcomes and toxicities after proton partial breast radiotherapy for early stage, hormone receptor positive breast cancer: 3-Year results of a phase II multi-center trial","volume":"37","author":"Choi","year":"2022","journal-title":"Clin Transl Radiat Oncol."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0026","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/1748-717X-8-71","article-title":"Proton radiotherapy for chest wall and regional lymphatic radiation; dose comparisons and treatment delivery","volume":"8","author":"MacDonald","year":"2013","journal-title":"Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0027","doi-asserted-by":"crossref","first-page":"2778","DOI":"10.1200\/JCO.18.02366","article-title":"Phase II study of proton beam radiation therapy for patients with breast cancer requiring regional nodal irradiation","volume":"37","author":"Jimenez","year":"2019","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0028","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.ijrobp.2022.08.036","article-title":"Serial measurement of global longitudinal strain among women With breast cancer treated with proton radiation rherapy: A prospective trial for 70 patients","volume":"115","author":"Hassan","year":"2023","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0029","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1016\/j.radonc.2017.04.007","article-title":"Proton beam radiotherapy as part of comprehensive regional nodal irradiation for locally advanced breast cancer","volume":"123","author":"Verma","year":"2017","journal-title":"Radiother Oncol"},{"issue":"5","key":"10.1016\/j.ijrobp.2026.08.017_bib0030","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1016\/j.ijrobp.2026.02.199","article-title":"Clinical hypothyroidism after proton versus photon regional nodal irradiation: A prospective correlative study within the RADCOMP randomized trial","volume":"125","author":"Neibart","year":"2026","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0031","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijrobp.2026.07.024","article-title":"Differential lung tissue response and patient outcomes between protons and photons receiving regional nodal irradiation for breast cancer: A Prospective Correlative Study within a Randomized Trial","author":"Salome","year":"2026","journal-title":"Int J Radiat Oncol Biol Phys."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0032","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.ijrobp.2007.05.075","article-title":"Treatment optimization using computed tomography-delineated targets should be used for supraclavicular irradiation for breast cancer","volume":"69","author":"Liengsawangwong","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0033","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1056\/NEJMoa1415369","article-title":"Internal mammary and medial supraclavicular irradiation in breast cancer","volume":"373","author":"Poortmans","year":"2015","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0034","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1056\/NEJMoa1415340","article-title":"Regional nodal irradiation in early-stage breast cancer","volume":"373","author":"Whelan","year":"2015","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0035","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1016\/S0140-6736(14)60488-8","article-title":"Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: Meta-analysis of individual patient data for 8135 women in 22 randomised trials","volume":"383","author":"McGale","year":"2014","journal-title":"Lancet"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0036","article-title":"Internal mammary node irradiation in 4541 node-positive breast cancer patients treated with newer systemic therapies and 3D-based radiotherapy (DBCG IMN2): A prospective, nationwide, population-based cohort study","volume":"49","author":"Nielsen","year":"2025","journal-title":"Lancet Reg Health Eur."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0037","doi-asserted-by":"crossref","first-page":"4198","DOI":"10.1200\/JCO.22.00044","article-title":"Internal mammary node irradiation in patients with node-positive early breast cancer: Fifteen-year results from the Danish Breast Cancer Group internal mammary node study","volume":"40","author":"Thorsen","year":"2022","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0038","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1200\/JCO.2015.63.6456","article-title":"DBCG-IMN: A population-based cohort study on the effect of internal mammary node irradiation in early node-positive breast cancer","volume":"34","author":"Thorsen","year":"2016","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0039","doi-asserted-by":"crossref","first-page":"275","DOI":"10.4048\/jbc.2016.19.3.275","article-title":"Radiation pneumonitis in association with internal mammary node irradiation in breast cancer patients: An ancillary result from the KROG 08-06 Study","volume":"19","author":"Choi","year":"2016","journal-title":"J Breast Cancer"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0040","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.radonc.2017.01.017","article-title":"Individual case review in a phase 3 randomized trial to investigate the role of internal mammary lymph node irradiation for breast cancer: Korean Radiation Oncology Group 08-06 study","volume":"123","author":"Yoon","year":"2017","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0041","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.ijrobp.2015.09.018","article-title":"Initial report of a prospective dosimetric and clinical feasibility trial demonstrates the potential of protons to increase the therapeutic ratio in breast cancer compared with photons","volume":"95","author":"Bradley","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0042","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.ijrobp.2015.01.005","article-title":"Early toxicity in patients treated with postoperative proton therapy for locally advanced breast cancer","volume":"92","author":"Cuaron","year":"2015","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0043","article-title":"Dosimetric and on-treatment clinical results of a volumetric-based skin-sparing planning technique for patients treated to the breast and chest wall with pencil-beam scanning proton therapy","volume":"10","author":"Rao","year":"2025","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0044","first-page":"S914","article-title":"Dosimetric comparison of skin surface dose in patients undergoing proton and photon radiation therapy for breast cancer","volume":"90","author":"Cuaron","year":"2014","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0045","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.radonc.2022.04.008","article-title":"Proton therapy for the treatment of inflammatory breast cancer","volume":"171","author":"Fattahi","year":"2022","journal-title":"Radiother Oncol."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0046","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.ijrobp.2014.10.039","article-title":"A novel approach to postmastectomy radiation therapy using scanned proton beams","volume":"91","author":"Depauw","year":"2015","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0047","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1002\/acm2.12733","article-title":"Validation of the RayStation Monte Carlo dose calculation algorithm using realistic animal tissue phantoms","volume":"20","author":"Schreuder","year":"2019","journal-title":"J Appl Clin Med Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0048","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1002\/acm2.12497","article-title":"A comprehensive dosimetric study of Monte Carlo and pencil-beam algorithms on intensity-modulated proton therapy for breast cancer","volume":"20","author":"Liang","year":"2019","journal-title":"J Appl Clin Med Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0049","unstructured":"Phase III randomized trial of conventionally fractionated vs. hypofractionated COMprehensive Nodal Irradiation for Breast Cancer Using Pencil Beam Scanning PROton Therapy (COMPRO). 2023. https:\/\/clinicaltrials.gov\/study\/NCT05856773."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0050","doi-asserted-by":"crossref","first-page":"269","DOI":"10.14338\/IJPT-22-00034.1","article-title":"Incidence of rib fracture following treatment with proton therapy for breast cancer","volume":"9","author":"Bradley","year":"2023","journal-title":"Int J Part Ther"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0051","doi-asserted-by":"crossref","first-page":"3428","DOI":"10.1002\/mp.17745","article-title":"Study of linear energy transfer effect on rib fracture in breast cancer patients receiving pencil-beam-scanning proton therapy","volume":"52","author":"Yang","year":"2025","journal-title":"Med Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0052","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1002\/acm2.13358","article-title":"Accuracy of proton stopping power estimation of silicone breast implants with single and dual-energy CT calibration techniques","volume":"22","author":"Chacko","year":"2021","journal-title":"J Appl Clin Med Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0053","article-title":"Intensity modulated proton therapy treatment planning for postmastectomy patients with metallic port tissue expanders","volume":"7","author":"Zhu","year":"2021","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0054","doi-asserted-by":"crossref","first-page":"e243","DOI":"10.1016\/j.prro.2016.12.002","article-title":"Initial clinical experience of postmastectomy intensity modulated proton therapy in patients with breast expanders with metallic ports","volume":"7","author":"Mutter","year":"2017","journal-title":"Pract Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0055","article-title":"Field-specific intensity-modulated proton therapy optimization technique for breast cancer patients with tissue expanders containing metal ports","volume":"9","author":"Kirk","year":"2017","journal-title":"Cureus"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0056","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.1016\/j.prro.2019.08.011","article-title":"Incorporation of biologic response variance modeling into the clinic: Limiting risk of brachial plexopathy and other late effects of breast cancer proton beam therapy","volume":"10","author":"Mutter","year":"2020","journal-title":"Pract Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0057","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.ijrobp.2022.05.011","article-title":"Beyond mean heart dose: Cardiac metrics for the modern era","volume":"114","author":"Jimenez","year":"2022","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0058","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.prro.2025.07.005","article-title":"Radiation-induced acute lung pneumonitis after pencil-beam scanning proton treatment for breast cancer: Correlation with dose-volume parameters and optimization objectives to reduce lung toxicities","volume":"16","author":"Park","year":"2026","journal-title":"Pract Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0059","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s10549-020-05747-7","article-title":"Optimal breast reconstruction type for patients treated with neoadjuvant chemotherapy, mastectomy followed by radiation therapy","volume":"183","author":"Naoum","year":"2020","journal-title":"Breast Cancer Res Treat"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0060","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.prro.2022.05.017","article-title":"Radiation modality (proton\/photon), timing, and complication rates in patients with breast cancer receiving 2-stages expander\/implant reconstruction","volume":"12","author":"Naoum","year":"2022","journal-title":"Pract Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0061","doi-asserted-by":"crossref","first-page":"e324","DOI":"10.1016\/j.ijrobp.2024.07.716","article-title":"Comparing protons vs photons on breast reconstruction outcomes and dosimetry analysis","volume":"120","author":"Naoum","year":"2024","journal-title":"Int J Radiat Oncol Biol Phys."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0062","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.ijrobp.2025.01.034","article-title":"Protons versus photons postmastectomy radiation therapy effects on breast reconstruction outcomes and dosimetry analysis","volume":"122","author":"Naoum","year":"2025","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0063","doi-asserted-by":"crossref","first-page":"S45","DOI":"10.1016\/j.ijrobp.2023.06.322","article-title":"Increased complication rates with proton therapy in breast cancer patients with immediate, implant-based reconstruction: Single-institution comparative effectiveness analysis","volume":"117","author":"Taghian","year":"2023","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0064","article-title":"Immediate 2-stage breast reconstruction outcomes after proton or photon postmastectomy radiotherapy","volume":"54","author":"Gao","year":"2025","journal-title":"Clin Transl Radiat Oncol."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0065","article-title":"Breast reconstruction complications after postmastectomy proton radiation therapy for breast cancer","volume":"9","author":"Berlin","year":"2023","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0066","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1097\/PRS.0000000000012232","article-title":"Comparative outcomes of proton versus photon postmastectomy radiation therapy in prepectoral implant-based breast reconstruction","volume":"156","author":"Desai","year":"2025","journal-title":"Plast Reconstr Surg"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0067","article-title":"Dose\u2013LET interactions predict capsular contracture after proton postmastectomy radiation therapy","author":"Chen","year":"2026","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0068","doi-asserted-by":"crossref","first-page":"66","DOI":"10.14338\/IJPT-21-00014","article-title":"Proton radiotherapy for patients with oligometastatic breast cancer involving the sternum","volume":"8","author":"Johnson","year":"2021","journal-title":"Int J Part Ther"},{"issue":"10","key":"10.1016\/j.ijrobp.2026.08.017_bib0069","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/S1470-2045(23)00388-1","article-title":"Conventional versus hypofractionated postmastectomy proton radiotherapy in the USA (MC1631): A randomised phase 2 trial","volume":"24","author":"Mutter","year":"2023","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0070","unstructured":"Shortening Adjuvant Photon and Proton Irradiation (SAPPHIRe-II): A 4 cohort, randomized, phase II multi-center trial evaluating shorter schedules of adjuvant regional nodal irradiation among women and men with node-positive and high-risk node-negative invasive breast cancer, 2025. https:\/\/clinicaltrials.gov\/study\/NCT07076485."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0071","doi-asserted-by":"crossref","DOI":"10.1088\/1361-6560\/ac344f","article-title":"Adaptive proton therapy","volume":"66","author":"Paganetti","year":"2021","journal-title":"Phys Med Biol"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0072","doi-asserted-by":"crossref","DOI":"10.1016\/j.radonc.2026.111548","article-title":"FLASH radiotherapy induces unique immunotranscriptomic profiles compared to conventional dose-rate radiotherapy, despite identical immune infiltration and antitumor efficacy in a murine model of triple-negative breast cancer","volume":"220","author":"Arrigo","year":"2026","journal-title":"Radiother Oncol."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0073","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.3390\/cancers17071095","article-title":"Effectiveness of FLASH vs. conventional dose rate radiotherapy in a model of orthotopic, murine breast cancer","volume":"17","author":"Melemenidis","year":"2025","journal-title":"Cancers (Basel)"},{"key":"10.1016\/j.ijrobp.2026.08.017_bib0074","unstructured":"Proton versus photon ultrahypofractionated radiation therapy and its impact on normal tissue, 2023. https:\/\/clinicaltrials.gov\/study\/NCT05912231."},{"key":"10.1016\/j.ijrobp.2026.08.017_bib75","doi-asserted-by":"crossref","first-page":"e377","DOI":"10.1016\/j.prro.2017.06.006","article-title":"Postmastectomy radiation therapy technique and cardiopulmonary sparing: A dosimetric comparative analysis between photons and protons with free breathing versus deep inspiration breath hold","volume":"7","author":"Patel","year":"2017","journal-title":"Pract Radiat Oncol"}],"container-title":["International Journal of Radiation Oncology*Biology*Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0360301626041957?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0360301626041957?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:35:42Z","timestamp":1792737342000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0360301626041957"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":75,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["S0360301626041957"],"URL":"https:\/\/doi.org\/10.1016\/j.ijrobp.2026.08.017","relation":{},"ISSN":["0360-3016"],"issn-type":[{"value":"0360-3016","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Proton Radiation for Locally Advanced Breast Cancer: Evolution and Techniques","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.2026.08.017","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}