Evidence map›Paper›PMID 41439248›Full record

ArticlePhysics and imaging in radiation oncology2025

Integrating spot-scanning proton arc therapy with functional avoidance strategies to reduce pulmonary toxicity.

Yingxuan Chen, Peilin Liu, Xiaoda Cong, Edward Castillo, Richard Castillo, Inga Grills, Craig Stevens, Xiangkun Xu, Xiaoqiang Li, Yevgeniy Vinogradskiy and 1 more

Abstract read
In one paragraph

Article in Physics and imaging in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yingxuan ChenDepartment of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA, United States.
Peilin LiuDepartment of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, United States.
Xiaoda CongDepartment of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, United States.
Edward CastilloDepartment of Biomedical Engineering, University of Texas at Austin, Austin, TX, United States.
Richard CastilloDepartment of Radiation Oncology, Emory University, Atlanta, GA, United States.
Inga GrillsDepartment of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, United States.
Craig StevensDepartment of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, United States.
Xiangkun XuDepartment of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, United States.
Xiaoqiang LiDepartment of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, United States.
Yevgeniy VinogradskiyDepartment of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA, United States.
Xuanfeng DingDepartment of Radiation Oncology, Corewell Health William Beaumont University Hospital, Royal Oak, MI, United States.

Funding

Develop a novel multi-approach dynamic Spot Scanning Proton Arc optimization frameworkR01CA301448 · NCI · WILLIAM BEAUMONT HOSPITAL RESEARCH INST · PI Xuanfeng Ding · 2025 to 2026
$2.2M
NCI NIH HHS R01 CA301448
6 · The paper itself

Abstract

Background and purpose: Functional avoidance radiotherapy has emerged as a promising technique using functional imaging to minimize pulmonary toxicity by reducing doses to functional lung. This study aims to investigate the potential dose-volume advantages of a novel spot-scanning proton arc (SPArc) therapy for functional avoidance radiotherapy with four-dimensional computed tomography (4DCT)-based ventilation imaging. Material and methods: Twenty-five patients from a prospective functional avoidance clinical trial treated with intensity-modulated photon radiotherapy were included. Robustly optimized intensity modulated proton therapy (IMPT) and SPArc plans were generated in RayStation. Functional lung contour was derived from the 4DCT-based ventilation imaging and utilized as an optimization structure in photon as well as IMPT and SPArc functional planning. The dose distributions were compared, and normal tissue complication probability (NTCP) models were applied to estimate the probability of pulmonary toxicity. Results: Using clinical photon plans as the baseline for comparison, both proton plans achieved equivalent target coverage and reduced dose to organs at risk. Compared with photon plans, the median absolute reduction of fV Conclusions: Our study highlighted the potential of SPArc to spare dose to functional lung. NTCP results further indicated that the risk of pulmonary complications can be reduced with SPArc compared to photon or IMPT for functional avoidance radiotherapy.

Indexed as

4DCT-based ventilation imagingFunctional avoidance therapyProton arc therapyPulmonary toxicitySpot-scanning

Identifiers

PMID41439248
PMCPMC12721199

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.