Document is current

Article History

Received: 13 January 2026

Accepted: 30 March 2026

First Online: 11 April 2026

Declarations

:

: This retrospective study utilized fully de-identified patient data obtained from routine clinical care. In accordance with the U.S. Department of Health and Human Services regulations (45 CFR 46), research involving the analysis of de-identified data does not constitute human subjects research and is therefore exempt from Institutional Review Board (IRB) oversight.The Oklahoma Proton Center does not maintain a local IRB; however, all study procedures were conducted in accordance with applicable federal guidelines and institutional policies governing the use of de-identified data.As this study involved only retrospective, de-identified data, the requirement for informed consent was waived.All methods were carried out in accordance with the Declaration of Helsinki.

: Not applicable.

: The authors declare no competing interests.