{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T15:49:26Z","timestamp":1765295366195,"version":"3.40.5"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T00:00:00Z","timestamp":1668384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19K08088"],"award-info":[{"award-number":["19K08088"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Sequential boost intensity\u2010modulated radiotherapy (SQB\u2010IMRT) uses two different planning CTs (pCTs) and treatment plans. SQB\u2010IMRT is a form of adaptive radiotherapy that allows for responses to changes in the shape of the tumour and organs at risk (OAR). On the other hand, dose accumulation with the two plans can be difficult to evaluate. The purpose of this study was to analyse patterns of loco\u2010regional failure using deformable image registration (DIR) in hypopharyngeal cancer patients treated with SQB\u2010IMRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2013 and 2019, 102 patients with hypopharyngeal cancer were treated with definitive SQB\u2010IMRT at our institution. Dose accumulation with the 1st and 2nd plans was performed, and the dose to the loco\u2010regional recurrent tumour volume was calculated using the DIR workflow. Failure was classified as follows: (i) in\u2010field (\u226595% of the recurrent tumour volume received 95% of the prescribed dose); (ii) marginal (20\u201395%); or (iii) out\u2010of\u2010field (&lt;20%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After a median follow\u2010up period of 25\u00a0months, loco\u2010regional failure occurred in 34 patients. Dose\u2013volume histogram analysis showed that all loco\u2010regional failures occurred in the field within 95% of the prescribed dose, with no marginal or out\u2010of\u2010field recurrences observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The dosimetric analysis using DIR showed that all loco\u2010regional failures were within the high\u2010dose region. More aggressive treatment may be required for gross tumours.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1754-9485.13491","type":"journal-article","created":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T12:11:20Z","timestamp":1668427880000},"page":"98-110","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Detailed analysis of failure patterns using deformable image registration in hypopharyngeal cancer patients treated with sequential boost intensity\u2010modulated radiotherapy"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7395-2254","authenticated-orcid":false,"given":"Manami","family":"Otsuka","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Hokkaido University Hospital  Sapporo Japan"},{"name":"Department of Radiation Oncology, Faculty and Graduate School of Medicine Hokkaido University  Sapporo 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