Accepted for Publication: September 29, 2020.
Published Online: March 4, 2021. doi:10.1001/jamaoncol.2020.7468
Corresponding Author: Icro Meattini, MD, Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, Viale Morgagni 50, 50134 Florence, Italy (icro.meattini@unifi.it).
Author Contributions: Dr Meattini had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Meattini and Poortmans contributed equally to the work.
Concept and design: Meattini, Poortmans, Cardinale, Lenihan, Marrazzo, Curigliano, Livi.
Acquisition, analysis, or interpretation of data: Meattini, Poortmans, Aznar, Becherini, Bonzano, Curigliano.
Drafting of the manuscript: Meattini, Poortmans, Aznar, Becherini, Bonzano, Cardinale, Marrazzo, Curigliano.
Critical revision of the manuscript for important intellectual content: Meattini, Poortmans, Aznar, Becherini, Cardinale, Lenihan, Marrazzo, Curigliano, Livi.
Administrative, technical, or material support: Meattini, Poortmans, Aznar, Becherini, Curigliano.
Supervision: Meattini, Poortmans, Cardinale, Lenihan, Curigliano, Livi.
Other - bibliographic research and manuscript writing, figures and tables: Marrazzo.
Other: Curigliano.
Conflict of Interest Disclosures: Dr Meattini reported serving on the advisory boards of Lilly, Pfizer, Roche, and Novartis outside the submitted work. Dr Poortmans reported being a medical advisor for Sordina IORT Technologies SpA. Dr Aznar reported receiving grants from the National Institute for Health Research Manchester Biomedical Research Centre and from the Cancer Research UK RadNet Manchester during the conduct of the study. Dr Lenihan reported receiving grants from Myocardial Solutions Inc outside the submitted work. Dr Marrazzo reported receiving financial support from Elekta to participate in the European Society for Radiotherapy and Oncology Congress. Dr Curigliano reported receiving grants from Merck and other from Roche, Novartis, Daiichi Sankyo, AstraZeneca, Lilly, Pfizer, Merck, BMS, and Ellipsis outside the submitted work. No other disclosures were reported.
Additional Contributions: Katherine Jones, MSc, The Christie NHS Foundation Trust; Giorgio Cartechini, MSc, University of Trento; and Marco Schwarz, MSc, PhD, Proton Therapy Center, provided permission to reprint the images in figures 2 and 3. These individuals received no additional compensation, outside of their usual salary, for their contributions.