Dosimetric superiority of proton radiosurgery in liver cancer: an in silico comparative dosimetric study
- 1Department of Radiation Oncology, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China
- 2Department of Radiotherapy and Oncology, Division of Life Sciences and Medicine, Hefei Ion Medical Center, The First Affiliated Hospital of USTC, University of Science and Technology of China
- 3Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences
Abstract
Background This in silico dosimetric study aimed to evaluate a potentially more efficient approach by assessing the dosimetric advantages of single-fraction 35 Gy proton radiosurgery relative to photon therapy. Methods This retrospective study included 98 patients with liver cancer who had undergone radiotherapy. Simulated treatment plans were generated for each patient to deliver a single fraction of 35 Gy using both photon and proton techniques. Patients were defined as eligible if all organs at risk (OARs) met the preset dose constraints. The Wilcoxon signed-rank test was applied to compare dosimetric parameters. The Youden index was used to identify the optimal cutoff for the safety margin between the OARs and the gross tumor volume. Results Proton therapy demonstrated a higher overall compliance rate with dose constraints compared to photon therapy, with notable improvements for key OARs, including the liver (96.9% vs. 88.8%), duodenum (93.9% vs. 91.8%), and heart (91.8% vs. 89.8%). Proton therapy plans provided superior sparing of OARs by significantly reducing the maximum dose to all organs (p < 0.0001) and the optimal cutoff for satisfying dose constraints was generally < 1 cm. Furthermore, proton therapy significantly reduced the irradiated liver volume (V5Gy and V11.6 Gy, both p < 0.05), and this benefit was consistent across tumor sizes (≤ 3 cm or > 3 cm) and locations (dome, caudal, left medial, or central). Conclusion Single-fraction 35 Gy proton radiosurgery offers enhanced sparing of OARs and a broader therapeutic window for patients with liver cancer compared with photon therapy from a dosimetric perspective. Whether these dosimetric benefits can translate into actual clinical efficacy requires prospective validation.
Related
- Comparison of endoplasmic reticulum chaperone gene expression and dosimetric findings before and after gamma knife radiosurgery in meningioma
- Superiority of magnetic resonance elastography and proton density fat fraction: an umbrella meta-analysis of non-invasive imaging for hepatic steatosis and fibrosis in metabolic dysfunction-associated steatotic liver disease and chronic hepatitis B.
- An App-Based Proton Pump Inhibitor Discontinuation Tool: A Multicentre, Open-Label, Randomised Superiority Trial.
- Comparative impact of proton versus photon irradiation on triple‐negative breast cancer: Role of VEGFC in tumour aggressiveness
- Evaluation of Neuroangiography Settings and Protective Shielding on Radiation Exposure to Patient and Interventionist: A Comparative Dosimetric Study
BibTeX
@article{li2026dosimetric,
title = {{Dosimetric superiority of proton radiosurgery in liver cancer: an in silico comparative dosimetric study}},
author = {Jiaran Li and Tao Ma and Hao Zhou and Changxing Feng and Lu Liu and Lei Liu and Li Li and Chao Shan and Dongdong Zheng and Shuanghu Yuan},
journal = {BMC Cancer},
year = {2026},
month = jul,
doi = {10.1186/s12885-026-16539-5},
url = {https://doi.org/10.1186/s12885-026-16539-5},
note = {CC BY},
}
RIS
TY - JOUR
TI - Dosimetric superiority of proton radiosurgery in liver cancer: an in silico comparative dosimetric study
AU - Jiaran Li
AU - Tao Ma
AU - Hao Zhou
AU - Changxing Feng
AU - Lu Liu
AU - Lei Liu
AU - Li Li
AU - Chao Shan
AU - Dongdong Zheng
AU - Shuanghu Yuan
PY - 2026
DA - 2026/07/01
JO - BMC Cancer
DO - 10.1186/s12885-026-16539-5
UR - https://doi.org/10.1186/s12885-026-16539-5
AB - Background This in silico dosimetric study aimed to evaluate a potentially more efficient approach by assessing the dosimetric advantages of single-fraction 35 Gy proton radiosurgery relative to photon therapy. Methods This retrospective study included 98 patients with liver cancer who had undergone radiotherapy. Simulated treatment plans were generated for each patient to deliver a single fraction of 35 Gy using both photon and proton techniques. Patients were defined as eligible if all organs at risk (OARs) met the preset dose constraints. The Wilcoxon signed-rank test was applied to compare dosimetric parameters. The Youden index was used to identify the optimal cutoff for the safety margin between the OARs and the gross tumor volume. Results Proton therapy demonstrated a higher overall compliance rate with dose constraints compared to photon therapy, with notable improvements for key OARs, including the liver (96.9% vs. 88.8%), duodenum (93.9% vs. 91.8%), and heart (91.8% vs. 89.8%). Proton therapy plans provided superior sparing of OARs by significantly reducing the maximum dose to all organs (p < 0.0001) and the optimal cutoff for satisfying dose constraints was generally < 1 cm. Furthermore, proton therapy significantly reduced the irradiated liver volume (V5Gy and V11.6 Gy, both p < 0.05), and this benefit was consistent across tumor sizes (≤ 3 cm or > 3 cm) and locations (dome, caudal, left medial, or central). Conclusion Single-fraction 35 Gy proton radiosurgery offers enhanced sparing of OARs and a broader therapeutic window for patients with liver cancer compared with photon therapy from a dosimetric perspective. Whether these dosimetric benefits can translate into actual clinical efficacy requires prospective validation.
SN - 1471-2407
ER -