{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T19:37:07Z","timestamp":1773344227015,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T00:00:00Z","timestamp":1562716800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study aimed to evaluate the feasibility of combining helical tomotherapy (<jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>) and intensity\u2010modulated proton therapy (<jats:styled-content style=\"fixed-case\">IMPT<\/jats:styled-content>) in treating patients with nasopharynx cancer (<jats:styled-content style=\"fixed-case\">NPC<\/jats:styled-content>). From January 2016 to March 2018, 98 patients received definitive radiation therapy (<jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>) with concurrent chemotherapy (<jats:styled-content style=\"fixed-case\">CCRT<\/jats:styled-content>). Using simultaneous integrated boost and adaptive re\u2010plan, 3 different dose levels were prescribed: 68.4\u00a0Gy in 30 parts to <jats:styled-content style=\"fixed-case\">gross tumor volume (GTV)<\/jats:styled-content>, 60\u00a0Gy in 30 parts to high\u2010risk <jats:styled-content style=\"fixed-case\">clinical target volume (CTV)<\/jats:styled-content>, and 36\u00a0Gy in 18 parts to low\u2010risk <jats:styled-content style=\"fixed-case\">CTV<\/jats:styled-content>. In all patients, the initial 18 fractions were delivered by <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>, and, after rival plan evaluation on the adaptive re\u2010plan, the later 12 fractions were delivered either by <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> in 63 patients (64.3%, <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content> only) or <jats:styled-content style=\"fixed-case\">IMPT<\/jats:styled-content> in 35 patients (35.7%, <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IMPT<\/jats:styled-content> combination), respectively. Propensity\u2010score matching was conducted to control differences in patient characteristics. In all patients, grade\u00a0\u2265\u00a02 mucositis (69.8% vs 45.7%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.019) and grade\u00a0\u2265\u00a02 analgesic usage (54% vs 37.1%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.110) were found to be less frequent in <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IMPT<\/jats:styled-content> group. In matched patients, grade\u00a0\u2265\u00a02 mucositis were still less frequent numerically in <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IMPT<\/jats:styled-content> group (62.9% vs 45.7%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.150). In univariate analysis, stage <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> disease and larger <jats:styled-content style=\"fixed-case\">GTV<\/jats:styled-content> volume were associated with increased grade\u00a0\u2265\u00a02 mucositis. There was no significant factor in multivariate analysis. With the median 14\u00a0month follow\u2010up, locoregional and distant failures occurred in 9 (9.2%) and 12 (12.2%) patients without difference by <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> modality. In conclusion, comparable early oncologic outcomes with more favorable acute toxicity profiles were achievable by <jats:styled-content style=\"fixed-case\">HT<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IMPT<\/jats:styled-content> combination in treating <jats:styled-content style=\"fixed-case\">NPC<\/jats:styled-content> patients.<\/jats:p>","DOI":"10.1111\/cas.14115","type":"journal-article","created":{"date-parts":[[2019,6,25]],"date-time":"2019-06-25T19:55:12Z","timestamp":1561492512000},"page":"2867-2874","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Early clinical outcomes of helical tomotherapy\/intensity\u2010modulated proton therapy combination in nasopharynx cancer"],"prefix":"10.1111","volume":"110","author":[{"given":"Seung Gyu","family":"Park","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Samsung Medical Center Sungkyunkwan University School of 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