ArticleInternational journal of radiation oncology, biology, physics2026
Technical Considerations on Proton Therapy in NRG's Multi-Institutional Clinical Trials.
Article in International journal of radiation oncology, biology, physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
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Authors and funding
18 authors.
Funding
Abstract
purposeIntegrating proton therapy into multi-institutional clinical trials introduces distinct physical and biological complexities. Modern pencil beam scanning enables highly conformal dose delivery but increases sensitivity to setup and range uncertainties, patient motion, interfractional anatomic changes, and variability in relative biological effectiveness. These factors complicate treatment standardization and outcome interpretation across institutions. METHODS AND MATERIALS: Under the leadership of NRG Oncology, current proton therapy clinical trial protocols were reviewed to identify technical challenges. Key issues examined included robustness evaluation, motion management, adaptive planning considerations, treatment reporting, and limitations in dosimetric and biological data collection. Recommendations were developed based on contemporary proton therapy practice and multi-institutional clinical trial experience.
resultsThis guideline establishes a harmonized framework for proton therapy in cooperative group clinical trials and provides practical recommendations for robustness evaluation, motion management, treatment reporting, and standardized data collection. Specifically, we recommend evaluating plan robustness directly on the clinical target volume using worst-case scenarios, rather than relying on conventional photon-based geometric expansions (planning target volume). Guidance is also provided for uncertainty parameters and minimum uncertainty scenario sets. In addition, expansion of centralized data collection through the Imaging and Radiation Oncology Core is recommended to include beam model parameters and linear energy transfer information to support independent dose reconstruction, cross-validation, and future retrospective radiobiological analyses as clinical relative biological effectiveness models evolve.
conclusionsThis unified framework aims to improve treatment consistency, outcome reliability, and harmonized proton therapy implementation across cooperative group clinical trials while supporting future investigation of biological dose-response relationships.
Identifiers
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Registered trials
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.