{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T20:46:34Z","timestamp":1793220394676,"version":"4.5.0"},"reference-count":25,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["12475359"],"award-info":[{"award-number":["12475359"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["12275357"],"award-info":[{"award-number":["12275357"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["2024-I2M-C&T-A-002"],"award-info":[{"award-number":["2024-I2M-C&T-A-002"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["E2024002"],"award-info":[{"award-number":["E2024002"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["12475359"],"award-info":[{"award-number":["12475359"]}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["12275357"],"award-info":[{"award-number":["12275357"]}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["2024-I2M-C&T-A-002"],"award-info":[{"award-number":["2024-I2M-C&T-A-002"]}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["E2024002"],"award-info":[{"award-number":["E2024002"]}]},{"name":"Teaching Research Fund of Cancer Hospital of Chinese Academy of Medical Sciences","award":["12475359"],"award-info":[{"award-number":["12475359"]}]},{"name":"Teaching Research Fund of Cancer Hospital of Chinese Academy of Medical Sciences","award":["12275357"],"award-info":[{"award-number":["12275357"]}]},{"name":"Teaching Research Fund of Cancer Hospital of Chinese Academy of Medical Sciences","award":["2024-I2M-C&T-A-002"],"award-info":[{"award-number":["2024-I2M-C&T-A-002"]}]},{"name":"Teaching Research Fund of Cancer Hospital of Chinese Academy of Medical Sciences","award":["E2024002"],"award-info":[{"award-number":["E2024002"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Introduction: Decision-making regarding radiotherapy techniques for patients with nasopharyngeal cancer requires a comparison of photon and proton plans generated using planning software, which requires time and expertise. We developed a fully automated decision tool to select patients for proton therapy that predicts proton therapy (XT) and photon therapy (PT) dose distributions using only patient CT image data, predicts xerostomia and dysphagia probability using predicted critical organ mean doses, and makes decisions based on the Netherlands\u2019 National Indication Protocol Proton therapy (NIPP) to select patients likely to benefit from proton therapy. Methods: This study used 48 nasopharyngeal patients treated at the Cancer Hospital of the Chinese Academy of Medical Sciences. We manually generated a photon plan and a proton plan for each patient. Based on this dose distribution, photon and proton dose prediction models were trained using deep learning (DL) models. We used the NIPP model to measure xerostomia levels 2 and 3, dysphagia levels 2 and 3, and decisions were made according to the thresholds given by this protocol. Results: The predicted doses for both photon and proton groups were comparable to those for manual plan (MP). The Mean Absolute Error (MAE) for each organ at risk in the photon and proton plans did not exceed 5% and showed a good performance of the dose prediction model. For proton, the normal tissue complication probability (NTCP) of xerostomia and dysphagia performed well, p &gt; 0.05. There was no statistically significant difference. For photon, the NTCP of dysphagia performed well, p &gt; 0.05. For xerostomia p &lt; 0.05 but the absolute deviation was 0.85% and 0.75%, which would not have a great impact on the prediction result. Among the 48 patients\u2019 decisions, 3 were wrong, and the correct rate was 93.8%. The area under curve (AUC) of operating characteristic curve (ROC) was 0.86, showing the good performance of the decision-making tool in this study. Conclusions: The decision tool based on DL and NTCP models can accurately select nasopharyngeal cancer patients who will benefit from proton therapy. The time spent generating comparison plans is reduced and the diagnostic efficiency of doctors is improved, and the tool can be shared with centers that do not have proton expertise. Trial registration: This study was a retrospective study, so it was exempt from registration.<\/jats:p>","DOI":"10.3390\/cancers17162620","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T09:04:53Z","timestamp":1754903093000},"page":"2620","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Decision-Making Method for Photon\/Proton Selection for Nasopharyngeal Cancer Based on Dose Prediction and NTCP"],"prefix":"10.3390","volume":"17","author":[{"given":"Guiyuan","family":"Li","sequence":"first","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyuan","family":"Chen","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jialin","family":"Ding","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linyi","family":"Shen","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengyang","family":"Li","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junlin","family":"Yi","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianrong","family":"Dai","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.canlet.2016.01.040","article-title":"Global trends in incidence and mortality of nasopharyngeal carcinoma","volume":"374","author":"Tang","year":"2016","journal-title":"Cancer Lett."},{"key":"ref_2","first-page":"7","article-title":"Nasopharyngeal Carcinoma Keys for Translational Medicine and Biology","volume":"Volume 778","author":"Busson","year":"2013","journal-title":"Advances in Experimental Medicine and Biology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.radonc.2022.01.043","article-title":"Evaluation of robustly optimised intensity modulated proton therapy for nasopharyngeal carcinoma","volume":"168","author":"Scandurra","year":"2022","journal-title":"Radiother. 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