Changes in Rectal Dose Due to Alterations in Beam Angles for Setup Uncertainty and Range Uncertainty in Carbon-Ion Radiotherapy for Prostate Cancer - Fig 3

<p>Data on one patient without a metal implant, for four field angles: (a) 0° field, (b) 30° field, (c) 60° field, and (d) 90° field. Green line shows prostate, light yellow line shows PTV, and magenta line shows rectum. (i) Dose distribution in the normal case. (ii) Yellow line shows the 95% isodose line for the prescription dose in the normal case, blue line shows the 95% isodose line of the prescription dose in the worst case, and red line shows the 95% isodose line of the prescription dose in the best case.</p

Averaging dose volume histogram (DVH) graphs of rectal dose and CTV dose.

<p>Red lines are the DVHs of the CTV dose shown as relative volume (%) and blue lines are DVHs of the rectal dose shown as absolute volume (cm³). (i) Ten patients in each beam angle. The light blue error bars represent the standard deviations for 10 patients. (ii) (e) is patient 1 with a 60° field. (f) is patient 2 with a 68° field. (g) is patient 3 with a −35° field. Patients in (e), (f) and (g) have hip implants and all fields avoid the implants. The solid lines show normal cases, and the dashed lines show the best or worst cases for setup and range uncertainties.</p

Patient information, CTVs, and rectal volumes.

<p>CTV shows the clinical target volume, metal implant shows which side the patient has in or not.</p

Increasing ratio graph of rectal mean dose from each uncertainty for the 10 patients enrolled in the study.

<p>(a) is the increasing ratio from setup uncertainty in anterior-posterior (AP), left-right (LR), and cranial-caudal (CC) directions, (b) is the ratio from range uncertainty, and (c) is the ratio from the setup and range uncertainties. The error bars represent the standard deviations for 10 patients. * in (a), and (b) show <i>p</i> < 0.05 using the Wilcoxon test, and * in (c) shows <i>p</i> < 0.05 using Dunnett’s multiple test.</p

Effect of X-ray irradiation on EL4 tumors in BALB/c-nu/nu mice.

<p>(A) Growth curves of EL4 tumors in the irradiated group (n = 5). X-ray irradiation was performed on Day 10; bars, SD. (B) Survival curves for EL4-inoculated BALB/c-<i>nu/nu</i> mice. (C) Systemic metastases (arrows) in the internal organs of a representative mouse 20 days after tumor inoculation.</p

Clinical case data of a patient with a metal implant.

<p>The upper row shows CT images and the bottom row shows CT images together with the dose distribution. Left column shows axial images, middle column shows sagittal images, and right column shows coronal images. Red lines show the metal implant after hip replacement. Green line shows prostate, light yellow line shows PTV, magenta line shows rectum, and purple line shows the bladder.</p

Beam parameters used in calculations for treatment planning for each field angle (n = 10).

<p>Beam parameters used in calculations for treatment planning for each field angle (n = 10).</p

Human leukocyte antigen (HLA) class I expression in tumor cells.

<p>Representative images showing HLA class I expression by rectal cancer cells. A, Grade 0 expression. B, Grade 1 expression. C, Grade 2 expression. D, Grade 3 expression. Magnification, ×200.</p

X-ray irradiation induces HMGB1 protein <i>in vitro.</i>

<p>Cells were exposed to the indicated doses of X-ray irradiation and then cultured for 48 h. HMGB1 concentrations in culture supernatants were measured by ELISA.</p

X-ray irradiation delays LL/C tumor growth, and CTL depletion reduces TGD, in C57BL/6 mice.

<p>(A) Growth curves of LL/C tumors in the non-treated group (open circles, n = 7), irradiated group (open triangles, n = 7), anti-CD8 antibody-treated group (closed circles, n = 3), and irradiation plus anti-CD8 antibody-treated group (closed triangles, n = 7). X-ray irradiation was performed when tumors reached 100 mm³ in volume (Day 0); bars, SD. (B) Survival curves for LL/C-inoculated C57BL/6 mice, non-treated group (thin solid line), irradiated group (thick solid line), anti-CD8 antibody-treated group (thin dotted line), and irradiation plus anti-CD8 antibody-treated group (thick dotted line).</p