{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:19:43Z","timestamp":1789564783518,"version":"build-2803163510"},"reference-count":61,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["25K11043"],"award-info":[{"award-number":["25K11043"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,25]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>This study evaluated the feasibility of pencil beam scanning (PBS) proton therapy for stereotactic body radiotherapy using an isodose prescription in patients with isolated early-stage lung cancer, comparing dose\u2013volume metrics with those of volumetric modulated arc therapy (VMAT). Treatment plans were generated for 10 patients with tumors located at least 2\u00a0cm from the trachea. Each plan prescribed 48\u00a0Gy(RBE) in four fractions with a 60% isodose prescription. Both multi-field optimized and single-field optimized PBS plans used four fields, while VMAT plans used two coplanar arcs. Plan robustness was assessed by simulating setup errors of \u00b15.0\u00a0mm and density uncertainties of \u00b13.5%, with worst-case target coverage also analyzed. Comparisons among the three planning strategies employed Bonferroni-adjusted multiple comparisons for target coverage, robustness, and organ-at-risk doses. PBS achieved target coverage comparable to VMAT, with similar D98% (63.2\u2009\u00b1\u20091.3 GyRBE vs. 64.0\u2009\u00b1\u20091.6\u00a0Gy; P\u2009=\u20090.12), mean doses (73.2\u2009\u00b1\u20090.8 GyRBE vs. 73.7\u2009\u00b1\u20091.2\u00a0Gy; P\u2009=\u20090.21), and robustness (D98%: 50.2\u2009\u00b1\u20090.9 GyRBE vs. 50.3\u2009\u00b1\u20091.1\u00a0Gy; P\u2009=\u20090.77). For the normal lung, PBS significantly reduced low-dose exposure up to V10Gy, whereas VMAT was more effective in reducing doses from V20Gy to the prescription level. All evaluated organ-at-risks received significantly lower mean doses with PBS than with VMAT (P\u2009&amp;lt;\u20090.05). Under a 60% isodose prescription for lung stereotactic body radiotherapy, multi-field optimized-based PBS proton therapy provides target coverage and robustness comparable to VMAT while offering superior normal tissue sparing.<\/jats:p>","DOI":"10.1093\/jrr\/rraf091","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T13:02:06Z","timestamp":1766149326000},"page":"236-247","source":"Crossref","is-referenced-by-count":1,"title":["Dosimetric comparison of scanned proton therapy and volumetric modulated arc therapy in isodose-prescribed stereotactic body radiotherapy for lung cancer"],"prefix":"10.1093","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7851-6213","authenticated-orcid":false,"given":"Yuki","family":"Tominaga","sequence":"first","affiliation":[{"name":"Department of Radiotherapy, Medical Co. Hakuhokai, Osaka Proton Therapy Clinic , 1-27-9, Kasugadenaka, Konohana-Ku, Osaka 554-0022 ,","place":["Japan"]},{"name":"Medical Physics Laboratory, Division of Health Science, Graduate School of Medicine, The University of Osaka , 1-7 Yamadaoka, Suita-Shi, Osaka 565-0871 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromitsu","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics and Technology, Southern Tohoku General Hospital , 115, Yatsuyamada 7 Chome, Koriyama, Fukushima 963-8563 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics and Technology, Southern Tohoku Proton Therapy Center , 172, Yatsuyamada 7 Chome, Koriyama, Fukushima 963-8052 ,","place":["Japan"]},{"name":"Department of Radiological Sciences, School of Health Sciences, Fukushima Medical University , 10-6 Sakae-machi, Fukushima, Fukushima 960-8516 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yushi","family":"Wakisaka","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Medical Co. Hakuhokai, Osaka Proton Therapy Clinic , 1-27-9, Kasugadenaka, Konohana-Ku, Osaka 554-0022 ,","place":["Japan"]},{"name":"Medical Physics Laboratory, Division of Health Science, Graduate School of Medicine, The University of Osaka , 1-7 Yamadaoka, Suita-Shi, Osaka 565-0871 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuyuki","family":"Higashikawa","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Medical Co. Hakuhokai, Osaka Proton Therapy Clinic , 1-27-9, Kasugadenaka, Konohana-Ku, Osaka 554-0022 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9530-0337","authenticated-orcid":false,"given":"Masao","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Southern Tohoku Proton Therapy Center , 172, Yatsuyamada 7 Chome, Koriyama, Fukushima 963-8052 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michinori","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Medical Co. Hakuhokai, Osaka Proton Therapy Clinic , 1-27-9, Kasugadenaka, Konohana-Ku, Osaka 554-0022 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"2026032605571040500_ref1","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.radonc.2020.02.025","article-title":"4D strategies for lung tumors treated with hypofractionated scanning proton beam therapy: dosimetric impact and robustness to interplay effects","volume":"146","author":"Mastella","year":"2020","journal-title":"Radiother Oncol"},{"key":"2026032605571040500_ref2","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1016\/j.ijrobp.2008.08.012","article-title":"Dose distribution analysis in stereotactic body radiotherapy using dynamic conformal multiple arc therapy","volume":"74","author":"Takeda","year":"2009","journal-title":"Int J Radiat Oncol Biol 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