{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:33:53Z","timestamp":1777941233492,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100018573","name":"Sun Yat-sen University Cancer Center","doi-asserted-by":"publisher","award":["qnrc-2024-07"],"award-info":[{"award-number":["qnrc-2024-07"]}],"id":[{"id":"10.13039\/501100018573","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82373211"],"award-info":[{"award-number":["82373211"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Technol Cancer Res Treat"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>To investigate the efficacy of a knowledge-based planning (KBP) model in optimizing dose distribution, and identify the inter-institutional variation in radiotherapy of recurrent nasopharyngeal carcinoma (rNPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 70 rNPC patients treated with intensity-modulated radiotherapy (IMRT) were recruited to build a KBP model. Following model refinement, 36 patients were retrospectively enrolled for dosimetric comparison between manually optimized and KBP-generated plans. Ten experienced physicists from six different institutions were engaged to independently design manual plan for a representative case, to assess inter-institutional variations, and differences between KBP and manual plans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The refined KBP model provided significant reduced dose in brainstem D\n                      <jats:sub>1cc<\/jats:sub>\n                      (the dose received by the \u201chottest\u201d1 cm\n                      <jats:sup>3<\/jats:sup>\n                      volume, 41.14\u2009\u00b1\u20098.51 Gy vs 38.48\u2009\u00b1\u20098.60 Gy,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and spinal cord D\n                      <jats:sub>1cc<\/jats:sub>\n                      (17.48\u2009\u00b1\u20099.38Gy vs 12.23\u2009\u00b1\u20096.56Gy,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001). In addition, The mean dose (D\n                      <jats:sub>mean)<\/jats:sub>\n                      of brainstem, spinal cord, mandible, parotid, temporomandibular joint and inner ear were statistically decreased (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.05). In validation cohort, KBP model eliminated the hotspot (0.57\u2009\u00b1\u20090.01% vs 0.00\u2009\u00b1\u20090.00%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001), improved target homogeneity (HI: 0.06\u2009\u00b1\u20090.00 vs 0.08\u2009\u00b1\u20090.00,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u20090.001), and performed superior to the manual plans in sparing organs. While all institutions achieved comparable target coverage, manual plans exhibited substantial variability in sparing brainstem. KBP implementation reduced inter-institutional dose disparities for brainstem (46.30\u2009\u00b1\u200910.08 Gy vs 41.80\u2009\u00b1\u20095.80 Gy,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.041) and spinal cord (26.08\u2009\u00b1\u20097.06 Gy vs 18.19\u2009\u00b1\u20091.98 Gy,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u20090.002). Additionally, planning efficiency increased by 48.7% (39 vs 76\u2005min).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This KBP framework optimized rNPC reirradiation from three dimensions: 1) Enhanced OARs\u2019 protection; 2) Improved target homogeneity; 3) Improved the multi-institutional consistency and efficiency of planning. These advancements established a clinically actionable paradigm for precision reirradiation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15330338251351535","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T02:33:06Z","timestamp":1750818786000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["\u2018Line\u2019 Constraints Optimization for Improved Dose Distribution in Locally Recurrent Nasopharyngeal Carcinoma Using Knowledge-Based Planning"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9315-5663","authenticated-orcid":false,"given":"Xiaoli","family":"Yu","sequence":"first","affiliation":[{"name":"State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China"},{"name":"Sun Yat-Sen Memorial Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yixuan","family":"Wang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingli","family":"Wang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huikuan","family":"Gu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7864-8518","authenticated-orcid":false,"given":"Xin","family":"Yang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3366-8798","authenticated-orcid":false,"given":"Jiang","family":"Hu","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tranon.2024.102243"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.01.005"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2024.110648"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2024.110660"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.11.024"},{"issue":"3","key":"e_1_3_2_7_2","article-title":"Recurrent nasopharyngeal carcinoma and the role of surgery","volume":"84","author":"Saraswathula A","year":"2023","unstructured":"Saraswathula A, London NRJr. Recurrent nasopharyngeal carcinoma and the role of surgery. 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