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1 Arts and Sciences IMRT Optimal bladder volume in IMRT planning for prostate cancer Key words: Prostate cancer, IMRT, 3D-CRT, Treatment planning, Bladder volume summary As for prostate cancer, surgical operation and a hormonotherapy have been performed, but in late years the radiotherapy comes into the limelight as one of the options, too. By the treatment with external irradiation, various research is accomplished, and treatment technique such as three dimensional conformal radiotherapy or the intensity modulated radiotherapy is used and become able to provide safe and effective treatment. Whereas it is the present conditions that examination about the bladder volumes at treatment plan is not accomplished. In our institution, we intended for 53 cases treated with IMRT for subjects of prostate cancer and retrospectively analyzed consequence such as DVH and the urination frequency and examined optimal bladder volumes. As a result, as for the optimal bladder volumes, it was recognized that 200 ml or more were desirable. 3 IMRT 53 DVH 200ml Intensity Modulated Radiation Therapy IMRT Yoshiyuki Kawasaki (36076), Yoshitaka Nemoto (51710), Hisanori Aoki (55385), Mayumi Kuronuma (46169), Yoshiyuki Seya (29333) Department of Radiology, Radiological Technologist, Hitachinaka General Hospital QOL 1-3 IMRT 1-3 IMRT Inverse planning IP Dose Volume Histogram DVH 4 IMRT vol.62 no.751

1 IMRT 1 2Gy 574GyIMRT IP 5-12 Table 1 ROI 0-49 50-99 100-149 150-199 200-249 250-299 300ml 7 DVH 1-1 2011 112012 4 IMRT 53 59 77 69

2 Fig. 1 Entry of a target and risk organ a Axial view b Sagittal view IMRT Table 1 The dose assessment standard of our facilities 1 IMRT CT MRI MRICT CTV PTV ROIFig.1 IMRT 1 2Gy 574GyIMRT IP 5-12 Table 1 ROI ml 7 DVH IMRT ml ELEKTA Synergy PHILIPS Pinacle 3 Ver. 9.0 CT SIEMENS SOMATOM Definition AS+ CIVCO Medical Solution MT- VL-B40 1-3DVH DVH 5-10 ROI4mm ROI BW V 20 V 40 V 50 V 60 V

1-4 International Prostate Symptom Score IPSS 40 8 DVH Normalized Volume Mann-Whitney U-test p<0.05 2 2-1DVH DVH Fig.

3 1-4 International Prostate Symptom Score IPSS 40 8 DVH Normalized Volume Mann-Whitney U-test p< DVH DVH Fig.2V 20 V 40 V 50 V 60 V 70 Table 2 53 Normalized Volume 200ml 200ml Normalized Volume Table 3150ml 150ml 2-2 Fig.3 200ml200ml 2 200ml Fig. 2 DVH curve every bladder volume Table 2 The average of normalized volume value every bladder volume vol.62 no.751

4 IMRT Arts and Sciences Table 3 The achievement ratio of the dose assessment standard about the bladder volume 05 Fig. 3 The increased urinating number of times a Daytime b Nighttime Table 4 The rate which was diagnosed as being frequent urination before and after radiation treatment Table 4 3 IMRT IMRT 53 DVH 200ml 80 Grade2Grade3 Grade , 13, 14 DVH Normalized Volume Fig.4 100ml IMRT DVH Normalized Volume IMRT 200ml

Fig. 4 The irradiation range every bladder volume a 100ml b 200ml c 300ml 200ml 100 150-199ml 500ml301 4 13-15 13-15 4 DVH IMRT 200ml 1 2012. 179-188, 2012. 2., 2013 3 2010. 962-967,, 2010 4 IMRT.

: Late damages associated with high-dose rate intraluminal brachytherapy and radiation therapy treating only one field each day analysis by the linear-quadratic model(ntd-2 Gy).

$Rectal bleeding after hypofractionated radiotherapy for prostate cancer. Correlation between clinical and dosimetric parameter and the incidence of grade 2 or worse rectal bleeding.$

5 Fig. 4 The irradiation range every bladder volume a 100ml b 200ml c 300ml 200ml ml 500ml DVH IMRT 200ml , , ,, IMRT. JASTRO NEWS LETTER No.3, 30-31, Nishimura K et al.: Late damages associated with high-dose rate intraluminal brachytherapy and radiation therapy treating only one field each day analysis by the linear-quadratic model(ntd-2 Gy). J Ther Radiol Oncol, 11: , Yaes RJ et al.: On using the Linear-quadratic model in daily clinical practice. Int J Radiat Oncol Biol Phys. 20: , Brenner DJ et al.: Fractionation and late rectal toxicity. Int J Radiat Oncol Biol Phys. 60: , Akimoto T et al.: Muramatsu H Takahashi M et al. Rectal bleeding after hypofractionated radiotherapy for prostate cancer. Correlation between clinical and dosimetric parameter and the incidence of grade 2 or worse rectal bleeding. Int J Radiat Oncol Biol Phys. 60: , Boersma et al.: Int.J.Radiat.Oncol.Biol.Phys. 41(1): 83-92, Ezzell GA et al.: Development of treatment planning protocol for prostate treatment using intensity modulated radiotherapy. J. Appli Clin Med Phys. 2: 59-68, Palta JR et al.: Intensity-Modulated Radiation Therapy. The state of the art. Medical physics publishing Storey M et al.: Complication from radiotherapy dose escalation in prostate cancer. Preliminary results of a randomized trial. Int J Radiat Oncol Biol Phys. 48(3): , Zelefsky MJ et al.: Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer. J Urol. 176: , Kuban DA et al.: Long-term results of the M. D. Anderson randomized dose-escalation trial for prostate cancer. Int J Radiat Oncol Biol Phys. 70: 67-74, Sysmex Journal, Vol.36 No.1, vol.62 no.751

06_学術_関節単純X線画像における_1c_梅木様.indd

06_学術_関節単純X線画像における_1c_梅木様.indd Arts and Sciences X The formulation of femoral heard measurement corrected enlargement ratio using hip joints X-ray Imaging 1 2 1 1 1 2 Key words: Bipolar Hip Arthroplasty (BHA) Preoperative planning Enlargement