ArticleJournal of applied clinical medical physics2026
Comparison of in-field secondary cancer risk based on therapeutic proton dose between proton arc therapy and intensity-modulated proton therapy in lung cancer patients.
Article in Journal of applied clinical medical 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
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
backgroundProton arc therapy (PAT) is an emerging delivery modality that delivers proton beams through continuous gantry rotation combined with spot scanning. Compared with intensity-modulated proton therapy (IMPT), PAT improves target conformity and spares organs at risk. However, the dynamic multi-angle irradiation pattern may alter the low-dose region distribution: the low-dose bath expands while the integral dose decreases. The net effect on secondary cancer risk, especially in radiosensitive lungs, remains unclear. Quantitative risk assessment is essential for clinical translation of PAT. PURPOSE: To quantitatively compare secondary lung cancer risk between PAT and IMPT using organ equivalent dose (OED) and lifetime attributable risk (LAR) models, and to assess cross-population robustness across China, France, Sweden, and Germany.
methodsData from 25 lung cancer patients (60 Gy/30 fractions) were retrospectively included. For each patient, robustly optimized IMPT and PAT plans were generated with a 3 mm setup and 3% range uncertainties across 21 error scenarios. Dosimetric parameters-ipsilateral lung
resultsUnder the linear model, PAT produced statistically markedly but modest reductions in absolute LAR for lungs (p < 0.001). Under the mechanistic model, reductions were markedly only in certain populations: ipsilateral lung in France (p = 0.001), Sweden (p < 0.001), Germany (p = 0.003); whole lungs in France (p = 0.046) and Sweden (p = 0.014); but not in China (p = 0.083; p = 1.000) or Germany for whole lungs (p = 0.317). No marked esophageal differences (p > 0.05). LAR ratios were consistent across countries (ipsilateral lung: 1.07-1.09; esophagus: 1.04-1.13), demonstrating robustness.
conclusionsPAT does not increase the modeled in-field secondary cancer risk in the lungs compared with IMPT and shows comparable risk for the esophagus. The risk reduction trend is robust across Chinese and European populations. These findings suggest that PAT does not increase modeled secondary lung cancer risk compared with IMPT and may even provide a modest risk reduction, providing quantitative evidence for clinical application.
Indexed as
Identifiers
What OpenQuestion holds
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.