Evidence map›Paper›PMID 41445933›Full record

ArticleClinical and translational radiation oncology2026

Evaluation of organ-specific relative biological effectiveness of proton therapy using radiation-induced pneumonitis as an endpoint.

Li Liao, Ting Xu, Mei Chen, Tingshi Su, Narayan Sahoo, Xiaorong Zhu, Steven J Frank, Quynh-Nhu Nguyen, Zhongxing Liao, Xiaodong Zhang

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical and translational radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Li LiaoDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Ting XuDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Mei ChenDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Tingshi SuDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Narayan SahooDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Xiaorong ZhuDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Steven J FrankDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Quynh-Nhu NguyenDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Zhongxing LiaoDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Xiaodong ZhangDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

Funding

Risk prediction and longitudinal assessment of cardiotoxicity and functional capacity trajectory in NSCLC patientsR01HL157273 · NHLBI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI LIAO, ZHONGXING · 2021 to 2025
$3.8M
NHLBI NIH HHS R01 HL157273
6 · The paper itself

Abstract

Background and purpose: Proton therapy has become widely used for non-small cell lung cancer (NSCLC) due to its ability to spare normal tissue. However, the commonly assumed relative biological effectiveness (RBE) of 1.1 may underestimate the therapy's true biological effects on lung, potentially leading to a higher than expected incidence of radiation-induced pneumonitis (RP). In this retrospective study, we evaluated the variability of organ-specific RBE of proton therapy using RP grade 2 or higher (RP2+) as an endpoint. Materials and methods: Data from 270 NSCLC patients across two clinical trials were analyzed, with 134 given photon therapy and 136 given proton therapy. The physical dose was obtained for all patients, and the dose-averaged linear energy transfer (LET Results: The estimated RBE for RP2+ in proton therapy recipients was variable and consistently exceeded 1.1. The RBE estimated from the photon-to-proton dose ratio model between 1.10 and 1.35, with an average of 1.28. While the LET-enhanced LKB model yielded an RBE range of 1.13 to 1.33, with an average of 1.23. Conclusion: This study demonstrated that the RBE of proton therapy for RP2+ is variable and higher than the conventional 1.1 assumption, emphasizing the need to account for variable RBE in treatment planning.

Indexed as

Linear Energy Transfer (LET)Lung cancerLyman-Kutcher-Burman (LKB) modelProton therapyRadiation pneumonitisRelative Biological Effectiveness (RBE)

Identifiers

PMID41445933
PMCPMC12723115

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LicenceCC BY-NC-ND
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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.