{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T16:02:25Z","timestamp":1783699345374,"version":"3.55.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["18K15577"],"award-info":[{"award-number":["18K15577"]}]},{"name":"JSPS KAKENHI","award":["22K15797"],"award-info":[{"award-number":["22K15797"]}]},{"name":"Regional R&D Proposal-Based Program from Northern Advancement Center for Science & Technology of Hokkaido Japan"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>This retrospective treatment-planning study was conducted to determine whether intensity-modulated proton therapy with robust optimization (ro-IMPT) reduces the risk of acute hematologic toxicity (H-T) and acute and late gastrointestinal toxicity (GI-T) in postoperative whole pelvic radiotherapy for gynecologic malignancies when compared with three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated X-ray (IMXT) and single-field optimization proton beam (SFO-PBT) therapies. All plans were created for 13 gynecologic-malignancy patients. The prescribed dose was 45 GyE in 25 fractions for 95% planning target volume in 3D-CRT, IMXT and SFO-PBT plans and for 99% clinical target volume (CTV) in ro-IMPT plans. The normal tissue complication probability (NTCP) of each toxicity was used as an in silico surrogate marker. Median estimated NTCP values for acute H-T and acute and late GI-T were 0.20, 0.94 and 0.58\u2009\u00d7\u200910\u22121 in 3D-CRT; 0.19, 0.65 and 0.24\u2009\u00d7\u200910\u22121 in IMXT; 0.04, 0.74 and 0.19\u2009\u00d7\u200910\u22121 in SFO-PBT; and 0.06, 0.66 and 0.15\u2009\u00d7\u200910\u22121 in ro-IMPT, respectively. Compared with 3D-CRT and IMXT plans, the ro-IMPT plan demonstrated significant reduction in acute H-T and late GI-T. The risk of acute GI-T in ro-IMPT plan is equivalent with IMXT plan. The ro-IMPT plan demonstrated potential clinical benefits for reducing the risk of acute H-T and late GI-T in the treatment of gynecologic malignances by reducing the dose to the bone marrow and bowel bag while maintaining adequate dose coverage to the CTV. Our results indicated that ro-IMPT may reduce acute H-T and late GI-T risk with potentially improving outcomes for postoperative gynecologic-malignancy patients with concurrent chemotherapy.<\/jats:p>","DOI":"10.1093\/jrr\/rrae008","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T05:37:56Z","timestamp":1710826676000},"page":"369-378","source":"Crossref","is-referenced-by-count":3,"title":["Probability of normal tissue complications for hematologic and gastrointestinal toxicity in postoperative whole pelvic radiotherapy for gynecologic malignancies using intensity-modulated proton therapy with robust optimization"],"prefix":"10.1093","volume":"65","author":[{"given":"Takaaki","family":"Yoshimura","sequence":"first","affiliation":[{"name":"Department of Health Sciences and Technology , Faculty of Health Sciences, , Sapporo 060-0812 , Japan"},{"name":"Hokkaido University , Faculty of Health Sciences, , Sapporo 060-0812 , Japan"},{"name":"Department of 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