{
  "abstract": "Purpose: The benefit of proton beam therapy (PBT) for primary brain tumors compared with x-ray therapy has not been demonstrated by randomized controlled trials. We performed a model-based approach study to evaluate the potential benefit of PBT for brain tumors using the normal tissue complication probability (NTCP) models complying with the Radiotherapy Treatment plannINg study Guidelines (RATING).\n\nMethods and Materials: Sixty-six patients with primary brain tumors treated with PBT were registered. We used 11 NTCP models, calculated NTCP for each adverse event, and estimated the PBT and intensity modulated radiation therapy (IMRT) plans for the entire patient population and for groups classified by pathology. Wilcoxon signed-rank tests were performed for statistically significant differences between the 2 modalities, and a 2-tailed test was considered significant when <.05. A reduction was considered clinically meaningful when the difference in NTCP between the 2 modalities (ΔNTCP) exceeded the prespecified threshold.\n\nResults: Overall, PBT reduced NTCP from the cataracts, delayed recall, memory impairment, contralateral hearing impairment, and tinnitus. Patients with meningiomas and low-grade gliomas had similar tendencies. PBT was associated with a lower excess absolute risk of secondary cancer of the central nervous system in all patients. However, NTCPs for alopecia, blindness, and brain necrosis were higher in the PBT cohort, highlighting important clinical trade-offs. Thirty-one patients (47.0%) had at least 1 ΔNTCP above the specified threshold.\n\nConclusions: In this model-based planning comparison, PBT was associated with lower estimated NTCPs for selected endpoints compared with virtual IMRT, whereas IMRT showed advantages for alopecia, blindness, and brain necrosis. PBT may offer meaningful clinical benefits, particularly in reducing the excess absolute risk of secondary cancer for patients with long-term survival. In addition, the comparison based on Radiotherapy Treatment plannINg study Guidelines made the study more objective than similar previous studies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan",
    "Global Center for Biomedical Science and Engineering, Hokkaido University Faculty of Medicine, Sapporo, Japan",
    "Department of Radiation Oncology, Hitachi, Ltd., Hitachinaka General Hospital, Hitachinaka, Japan",
    "Department of Radiation Oncology, University of Tsukuba, Tsukuba, Japan",
    "Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Japan",
    "Proton Therapy Center, Fukui Prefectural Hospital, Fukui, Japan",
    "Department of Radiology, Tsuyama Chuo Hospital, Tsuyama, Japan",
    "Medipolis Proton Therapy and Research Center, Ibusuki, Japan",
    "Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City University West Medical Center, Nagoya, Japan",
    "Proton Therapy Center, Sapporo Teishinkai Hospital, Sapporo, Japan",
    "Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan",
    "Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan",
    "Proton Therapy Center, Aizawa Hospital, Matsumoto, Japan",
    "Radiation and Proton Therapy Center, Shizuoka Cancer Center Hospital, Nagaizumi-cho, Japan",
    "Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 20,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Hajime Higaki"
    },
    {
      "affs": [
        1
      ],
      "name": "Kentaro Nishioka"
    },
    {
      "affs": [
        1
      ],
      "name": "Kohei Yokokawa"
    },
    {
      "affs": [
        0
      ],
      "name": "Keiji Nakazato"
    },
    {
      "affs": [
        0
      ],
      "name": "Izuru Otake"
    },
    {
      "affs": [
        1
      ],
      "name": "Keiji Kobashi"
    },
    {
      "affs": [
        2
      ],
      "name": "Atsushi Motegi"
    },
    {
      "affs": [
        3
      ],
      "name": "Hideyuki Sakurai"
    },
    {
      "affs": [
        4
      ],
      "name": "Masao Murakami"
    },
    {
      "affs": [
        5
      ],
      "name": "Hiroyasu Tamamura"
    },
    {
      "affs": [
        6
      ],
      "name": "Takahiro Waki"
    },
    {
      "affs": [
        7
      ],
      "name": "Takashi Ogino"
    },
    {
      "affs": [
        8
      ],
      "name": "Hiromitsu Iwata"
    },
    {
      "affs": [
        9
      ],
      "name": "Masaru Takagi"
    },
    {
      "affs": [
        10
      ],
      "name": "Tomoaki Okimoto"
    },
    {
      "affs": [
        11
      ],
      "name": "Sadamoto Zenda"
    },
    {
      "affs": [
        12
      ],
      "name": "Masayuki Araya"
    },
    {
      "affs": [
        13
      ],
      "name": "Shigeyuki Murayama"
    },
    {
      "affs": [
        14
      ],
      "name": "Hideya Yamazaki"
    },
    {
      "affs": [
        0
      ],
      "name": "Hidefumi Aoyama"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2e49harszcpfx.bib",
  "cited_by": 0,
  "doi": "10.1016/j.adro.2026.102216",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13697817/",
  "id": "2e49harszcpfx",
  "issns": [
    "2452-1094"
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  "landing_url": "https://doi.org/10.1016/j.adro.2026.102216",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Scientific Article"
    ],
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      "openalex",
      "2740|Radiation Therapy and Dosimetry"
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  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13697817/pdf/?tool=EBI",
  "pmcid": "PMC13697817",
  "pmid": "42936426",
  "published": "2026-10-19",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/2e49harszcpfx.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:48Z",
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      "url": "https://doi.org/10.1016/j.adro.2026.102216"
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    {
      "first_seen": "2026-10-30T12:21:25Z",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Radiation Therapy and Dosimetry",
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  ],
  "title": "Model-Based Normal Tissue Complication Probability Comparison Between Proton and Photon Therapies for Brain Tumors Complying With Planning Study Guidelines",
  "title_text": "Model-Based Normal Tissue Complication Probability Comparison Between Proton and Photon Therapies for Brain Tumors Complying With Planning Study Guidelines",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:34:47Z",
  "url": "https://research.draconitic.com/paper/2e49harszcpfx",
  "venue": "Advances in Radiation Oncology",
  "versions": []
}