• Radiation Oncology Journal
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• v.19 no.3
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• pp.216-223
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• 2001

Purpose : We evaluated retrospectively the outcomes of inoperable squamous cell lung cancer patients treated with radiotherapy to find out prognostic factors affecting survival. Materials and methods : Four hundred and eleven patients diagnosed as squamous cell lung cancer between November 1988 and December 1997 were the basis of this analyses. The planned dose to the gross tumor volume was ranged from 30 to 70.2 Gy. Chemotherapy was combined in 72 patients $(17.5\%)$ with the variable schedule and drug combination regimens. Follow-up period ranged from 1 to 113 months with the median of 8 months and survival status was identified in 381 patients $(92.7\%)$. Overall survival rate was calculated using the Kaplan-Meier method. Results : Age ranged from 23 years to 83 years with the median 63 years. The male to female ratio was about 16:1. For all 411 patients, the median overall survival was 8 months and the 1-year survival rate (YSR), 2-YSR, and 5-YSR were $35.6\%,\;12.6\%,\;and\;3.7\%$, respectively. The median and 5-YSR were 29 months and $33.3\%$ for Stage IA, 13 months and $6.3\%$ for Stage IIIA, and 9 months and $3.4\%$ for Stage IIIB, respectively(p=0.00). The median survival by treatment aim was 11 months in radical intent group and 5 months in palliative, respectively (p=0.00). Of 344 patients treated with radical intent, median survival of patients (N=247) who received planned radiotherapy completely was 12 months while that of patients (N=97) who did not was 5 months (p=0.0006). In the analyses of the various prognostic factors affecting to the survival outcomes in 247 patients who completed the planned radiotherapy, tumor location, supraclavicular LAP, SVC syndrome, pleural effusion, total lung atelectasis and hoarseness were statistically significant prognostic factors both in the univariate and multivariate analyses while the addition of chemotherapy was statistically significant only in multivariate analyses. The acute radiation esophagitis requiring analgesics was appeared in 49 patients $(11.9\%)$ and severe radiation esophagitis requiring hospitalization was shown in 2 patients $(0.5\%)$. The radiation pneumonitis requiring steroid medication was shown in 62 patients $(15.1\%)$ and severe pneumonitis requiring hospitalization was occurred in 2 patients $(0.5\%)$. During follow-up, 114 patients $(27.7\%)$ had progression of local disease with 10 months of median time to recur (range : $1\~87\;months$) and 49 patients $(11.9\%)$ had distant failure with 7 months of median value (range : $1\~52\;months$). Second malignancy before or after the diagnosis of lung cancer was appeared in 11 patients Conclusion : The conventional radiotherapy in the patients with locally advanced squamous cell lung cancer has given small survival advantage over supportive care and it is very important to select the patient group who can obtain the maximal benefit and to select the radiotherapy technique that would not compromise the life quality in these patients.

• Radiation Oncology Journal
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• v.19 no.3
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• pp.275-286
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• 2001

Purpose : To setup procedures of quality assurance (OA) for implementing intensity modulated radiation therapy (IMRT) clinically, report OA procedures peformed for one patient with prostate cancer. Materials and methods : $P^3IMRT$ (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the positional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was peformed again to consider small field effect. After RTP recommissioning, a test plan of a C-shaped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one in solid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned using 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were measured with a 0.015 cc micro-ionization chamber, a diode detector, films, and an array detector and compared with calculated one. Results : The positioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured $1.9\%$ and midleaf leakage $0.9\%$ relative to $10\times\;cm^2$ open filed. Penumbra measured with film, diode detector, microionization chamber, and conventional 0.125 cc chamber showed that $80\~20\%$ penumbra width measured with a 0.125 cc chamber was 2 mm larger than that of film, which means a 0.125 cc ionization chamber was unacceptable for measuring small field such like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the measured and calculated dose profile for a small field of $1\times1\;cm^2$ size was less than $2\%$. The isocenter dose of the test plan of C-shaped PTV was measured two times with micro-ionization chamber in solid phantom showed that the errors upto $12\%$ for individual beam, but total dose delivered were agreed with the calculated within $2\%$. The transverse dose distribution measured with EC-L film was agreed with the calculated one in general. The isocenter dose for the patient measured in solid phantom was agreed within $1.5\%$. On-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about $2\%$, at inside-the-field the measured one was agreed within $3\%$, except some position. Conclusion : It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a micro-ionization chamber, film dosimetry for verifying intensity pattern, and another measurement with an array detector for comparing off-axis dose profile.

• Radiation Oncology Journal
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• v.16 no.4
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• pp.485-495
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• 1998

Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 50 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patients with median follow up duration 50 months (range 6-162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58$\%$) was the most frequent site of occurrence followed by trunk (20$\%$) and head and neck (12$\%$). Histologically malignant fibrous histiocytoma (23$\%$), liposarcoma (17$\%$), malignant schwannoma (12$\%$) constitute 52$\%$ of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42$\%$) received chemotherapy with various regimen in the postoperative period. Results : Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48$\%$) of local recurrence. Four patients (7$\%$) developed simultaneous local recurrence and distant metastasis and 8 patients (13$\%$) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck Primary This feature is likely explanation for the decreased local control rate. Five of 29 Patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 $\%$, 30.6$\%$ respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.2
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• pp.169-177
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• 1999

Purpose: To evaluate the efficacy of interferon alpha therapy with or without prednisolone in children with chronic hepatitis B. Methods: Twenty-eight children (22 boys, 6 girls, mean age 130 months) had seropositive results for HBsAg, HBeAg and HBV DNA; 11 had chronic persistent hepatitis and 17 had chronic active hepatitis. The patients were divided into two groups depending upon their inflammatory activity on liver biopsy, pretreatment serum ALT levels and HBV DNA levels. Fourteen children (group 1: chronic active hepatitis, ALT ${\geq}$ 100 IU/L and HBV DNA ${\leq}$ 100 pg/$300\;{\mu}L$) received interferon alpha 2a 5 $MU/m^2$ of body surface three times weekly for 6 months. Fourteen children (group 2: chronic persistent hepatitis or chronic active hepatitis with ALT < 100 IU/L or HBV DNA > 100 pg/$300\;{\mu}L$) received prednisolone in decreasing daily doses of 60 mg/$m^2$, 40 mg/$m^2$, and 20 mg/$m^2$, each for 2 weeks, followed after 2 weeks by interferon alpha 2a on the same schedule. At the end of therapy, 3 end points were analyzed: HBeAg seroconversion, serum ALT normalization rate and clearance of serum HBV DNA. Results: At the end of treatment, HBe antigen-to antibody seroconversion was higher but not more significant in group 1 than group 2 (71.4% vs. 50.0%). Only one patient in group 2 who lost HBeAg, also cleared HBsAg. ALT normalization was similar in both groups (64.3% in group 1 vs. 55.6% in group 2). Clearance of serum HBV DNA was observed in 78.6% of patients in group 1 and 64.3% in group 2, but no significant differences. Complete response was similarly achieved in both groups (57.1% in group 1 vs. 50.0% in group 2). Interferon alpha therapy with prednisolone priming was well tolerated and all children finished therapy. Conclusion: The combined therapy with prednisolone followed by interferon alpha may be safe and effective in inducing a serological and biochemical remission of the disease in approximately 50% of children with chronic hepatitis B and with a high level of viral replication and less active disease. However, a controlled study should be performed to confirm these results.

• Journal of Hospice and Palliative Care
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• v.4 no.1
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• pp.14-25
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• 2001

Purpose : To determine whether there exist gender differences in pain in Korean cancer patients and whether the depression and performance that are often expressed differently between men and women with cancer interact with pain. Method : The results of survey were collected from 140 in- and out-patients (78 male and 62 female) who had cancer treatment at one of the university hospital in Seoul for four months from February of 1999. The severity and interference of pain were examined with the self-reported survey based on Korean version of Brief Pain Inventory (BPI-K). Demographic and clinical information for all patient were compiled by reviewing their medical records, and the level of depression was examined with the Korean version of Beck Depression Inventory (BDI-K). Usual statistical methods, e.g., frequences, means and SDs were used to characterize the sample. The chi-square tests for categorical data and t-test for numerical data were used for group comparison. And the correlation between variables were performed using Pearson correlation coefficient. Resuts : 1) The mean scores of the worst pain for last 24-hours measured with the pain severity of BPI-K were 5.77 in male and 6.45 in female. The pain interference of BPI-K in men was in the order of mood (5.49), enjoy (5.36), and work (5.00), and in women were work (7.48), enjoy (7.16), and mood (6.53). 2) In pain severity, significant difference was found between men and women in the average pain for last 24-hours (t=-2.130, P=.035). In pain interference, significant difference was found between men and women in activity (t=-2.450, P=.015), mood (t=-2,321, P=.022), walk (t=-2.762, P=.007), work (t=-4.946, P=.000), relate (t=-2.595, P=.010), sleep (t=-2.071, P=.040), enjoy (t=-3.198, P=.001). 3) It was found that the items of pain and depression are significantly correlated in men but not in women. Men also exhibited higher correlation in the items of pain and performance status than women. Conclusions : Women report significantly greater average pain for last 24-hours and for all items of pain interference than men. Pain and depression are significantly correlated in men. The results of this study suggest that gender differences in pain should be considered for planning effective pain management program.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.1
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• pp.25-34
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• 2019

Objectives : This study aimed to compare the psychosocial characteristics among patients with functional gastrointestinal disorder (FGID), adults with functional gastrointestinal symptoms, and normal control group and investigate factors related to quality of life (QoL) of FGID patients. Methods : 65 patients diagnosed with FGID were selected. 79 adults were selected as normal control group based on the Rome III diagnostic criteria, and 88 adults who showed functional gastrointestinal symptoms were selected as "FGID positive group". Demographic factors were investigated. Psychosocial factors were evaluated using the Korean-Beck Depression Inventory-II, Korean-Beck Anxiety Inventory, Korean-Childhood Trauma Questionnaire, Multi-dimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale and WHO Quality of Life Assessment Instrument Brief Form. A one-way ANOVA was used to compare differences among groups. Pearson correlation test was used to analyze correlations between QoL and psychosocial factors in patients with FGID. Results : There were group differences in the education level. Depression (F=29.012, p<0.001), anxiety (F=27.954, p<0.001) and Childhood trauma (F=7.748, p<0.001) were significantly higher in FGID patient group than in both FGID-positive and normal control group. Social support (F=5,123, p<0.001), Resilience (F=9.623, p<0.001) and QoL (F=35.991, p<0.001) were significantly lower in the FGID patient group than in others. QoL of FGID patients showed a positive correlation with resilience (r=0.475, p<0.01), and showed a negative correlation with depression (r=-0.641, p<0.01), anxiety (r=-0.641, p<0.01), and childhood trauma (r=-0.278, p<0.05). Conclusions : FGID patients have distinctive psychosocial factors compared to the both FGID-positive and normal control group. Therefore, the active interventions for psychosocial factors are required in the treatment of patients with FGID.

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.1
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• pp.57-65
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• 2019

Purpose: The purpose is to clarify the effect of additional scattering ratio on the edge of the block according to the increasing block thickness with low melting point lead alloy and pure lead in electron beam therapy. Methods and materials: $10{\times}10cm^2$ Shielding blocks made of low melting point lead alloy and pure lead were fabricated to shield mold frame half of applicator. Block thickness was 3, 5, 10, 15, 20 (mm) for each material. The common irradiation conditions were set at 6 MeV energy, 300 MU / Min dose rate, gantry angle of $0^{\circ}$, and dose of 100 MU. The relative scattering ratio with increasing block thickness was measured with a parallel plate type ion chamber(Exradin P11) and phantom(RW3) by varying the position of the shielding block(cone and on the phantom), the position of the measuring point(surface ans depth of $D_{max}$), and the block material(lead alloy and pure lead). Results : When (depth of measurement / block position / block material) was (surface / applicator / pure lead), the relative value(scattering ratio) was 15.33 nC(+0.33 %), 15.28 nC(0 %), 15.08 nC(-1.31 %), 15.05 nC(-1.51 %), 15.07 nC(-1.37 %) as the block thickness increased in order of 3, 5, 10, 15, 20 (mm) respectively. When it was (surface / applicator / alloy lead), the relative value(scattering ratio) was 15.19 nC(-0.59 %), 15.25 nC(-0.20 %), 15.15 nC(-0.85 %), 14.96 nC(-2.09 %), 15.15 nC(-0.85 %) respectively. When it was (surface / phantom / pure lead), the relative value(scattering ratio) was 15.62 nC(+2.23 %), 15.59 nC(+2.03 %), 15.53 nC(+1.67 %), 15.48 nC(+1.31 %), 15.34 nC(+0.39 %) respectively. When it was (surface / phantom / alloy lead), the relative value(scattering ratio) was 15.56 nC(+1.83 %), 15.55 nC(+1.77 %), 15.51 nC(+1.51 %), 15.42 nC(+0.92 %), 15.39 nC(+0.72 %) respectively. When it was (depth of $D_{max}$ / applicator / pure lead), the relative value(scattering ratio) was 16.70 nC(-10.87 %), 16.84 nC(-10.12 %), 16.72 nC(-10.78 %), 16.88 nC(-9.93 %), 16.90 nC(-9.82 %) respectively. When it was (depth of $D_{max}$ / applicator / alloy lead), the relative value(scattering ratio) was 16.83 nC(-10.19 %), 17.12 nC(-8.64 %), 16.89 nC(-9.87 %), 16.77 nC(-10.51 %), 16.52 nC(-11.85 %) respectively. When it was (depth of $D_{max}$ / phantom / pure lead), the relative value(scattering ratio) was 17.41 nC(-7.10 %), 17.45 nC(-6.88 %), 17.34 nC(-7.47 %), 17.42 nC(-7.04 %), 17.25 nC(-7.95 %) respectively. When it was (depth of $D_{max}$ / phantom / alloy lead), the relative value(scattering ratio) was 17.45 nC(-6.88 %), 17.44 nC(-6.94 %), 17.47 nC(-6.78 %), 17.43 nC(-6.99 %), 17.35 nC(-7.42 %) respectively. Conclusions: When performing electron therapy using a shielding block, the block position should be inserted applicator rather than the patient's body surface. The block thickness should be made to the minimum appropriate shielding thickness of each corresponding using energy. Also it is useful that the treatment should be performed considering the influence of scattering dose varying with distance from the edge of block.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.29 no.4
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• pp.14-26
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• 2011

Imdaejeong Wonlim is located on the verge of Sangsa Village in Sapyeong-ri, Daepyeong-myeon, Hwasun-gun Gyeongsangnam-do toward Northwest. It was planned by Sa-ae, Minjuhyeon in 1862 on the basis of Gobanwon built by Nam Eongi in 16th century against the backdrop of Mt. Bongjeong and facing Sapyeong Stream. As water flows from west to east in the shape of crane, this area is a propitious site standing for prosperity and happiness. This area shows a distinct feature of Wonlim surrounding the Imdaejeong with multi layers as consisting of 5 districts - front yard where landmark stone with engraved letters of 'Janggujiso of Master Sa-ea' and junipers are harmoniously arranged, internal garden of upper pavilion ranging from a pavilion to square pond with a little island in the middle, Sugyeongwon of under pavilionu consisting of 2 ponds with a painting of three taoist hermits, forest of Mt. Bonggeong and external garden including Sapyeong Stream and farmland. According to documentation and the results of on-site investigation, it is certainly proved that Imdaejeong Wonlim was motivated by Byeoseo Wonlim which realized the idea of 'going back to hometown after resignation' following the motives of Janggujiso, a hideout aimed to accomplish the ideology, 'training mind and fostering innate nature,' on the peaceful site surrounded by water and mountain, as well as motives of Sesimcheo(洗心處) to be unified with morality of Mother Nature, etc. In addition, it implies various imaginary landscapes such as Pihangji, Eupcheongdang, square pond with an island and painting of three Taoist hermits based on a notion that 'the further scent flies away, the fresher it becomes,' which is originated from Aelyeonseol(愛蓮說). In terms of technique of natural landscape treatment, divers techniques are found in Imdaejeong Wonlim such as distant view of Mt. Bongjeong, pulling view with an intention of transparent beauty of moonlight, circle view of natural and cultural sceneries on every side, borrowed scenary of pastoral rural life adopted as an opposite view, looked view of Sulyundaero, over looked view of pond, static view in pavilion and paths, close view of water space such as stream and pond, mushroom-and-umbrella like view of Imdaejeong, vista of pond surrounded by willows, imaginary view of engraved letters meaning 'widen knowledge by studying objectives' and selected view to comprise sunrise and sunset at the same time. In the beginning of construction, various plants seemed to be planted, albeit different from now, such as Ginkgo biloba, Phyllostachys spp., Salix spp., Pinus densiflora, Abies holophylla, Morus bombycis, Juglans mandschurica, Paulownia coreana, Prunus mume, Nelumbo nucifera, etc. Generally, it reflected dignity of Confucianism or beared aspect of semantic landscape implying Taoist taste and idea of Phoenix wishing a prosperity in the future. Furthermore, a diversity of planting methods were pursued for such as liner planting for the periphery of pond, bosquet planting and circle planting adopted around the pavilion, spot planting using green trees, solitary planting of monumentally planted Paulownia coreana and opposite planting presenting the Abies holophylla into yin and yang.

• (The)Study of the Eastern Classic
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• no.72
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• pp.365-400
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• 2018

The signs of $G{\bar{a}}nzh{\bar{i}}$(干支: the sexagesimal calendar system) almanac, which marked each year, month, day and time with 60 ordinal number marks made by combining 10 $Ti{\bar{a}}ng{\bar{a}}ns$(天干: the decimal notation to mark date) and 12 $D{\grave{i}}zh{\bar{i}}s$(地支 : the duodecimal notation to mark date), were used not only as the sign of the factors affecting the occurrence of a disease and treatment in the area of traditional oriental medicine, but also as the indicator of prejudging fortunes in different areas of future prediction techniques.(for instance, astrology, the theory of divination based on topography, four pillars of destiny and etc.) While theories of many future predictive technologies with this $G{\bar{a}}nzh{\bar{i}}$(干支) almanac signs as the standard had been established in many ways by Han dynasty, it is difficult to find almanac discussion later on the fundamental theory of 'how it works like that'. As for the method to mark the era of $Ti{\bar{a}}nt{\check{i}}l{\grave{i}}$(天體曆: a calendar made with the sidereal period of Jupiter and the Sun), which determines the name of a year depending on where $Su{\grave{i}}x{\bar{i}}ng$(歲星: Jupiter) is among the '12 positions of zodiac', there are three main ways of $$Su{\grave{i}}x{\bar{i}}ng-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(歲星紀年法: the way to mark an era by the location of Jupiter on the celestial sphere), $$T{\grave{a}}isu{\grave{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$ (太歲紀年法: the way to mark an era by the location facing the location of Jupiter on the celestial sphere) and $$G{\bar{a}}nzh{\bar{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(干支紀年法: the way to mark an era with Ganzhi marks). Regarding $$G{\bar{a}}nzh{\bar{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(干支紀年法), which is actually the same way to mark an era as $$T{\grave{a}}isu{\grave{i}}-J{\grave{i}}ni{\acute{a}}nf{\check{a}}$$(太歲紀年法) with the only difference in the name, there are more than three ways, and one of them has continued to be used in China, Korea and so on since Han dynasty. The name of year of $G{\bar{a}}nzh{\bar{i}}$(干支) this year, 2018, has become $W{\grave{u}}-X{\bar{u}}$(戊戌) just by 'accident'. Therefore, in this discussion, the need to realize this situation was emphasized in different areas of traditional techniques of future prediction in which distinct theories have been established with the $G{\bar{a}}nzh{\bar{i}}$(干支) mark of year, month, day and time. Because of the 1 sidereal period of Jupiter, which is a little bit shorter than 12 years, once about one thousand years, 'the location of Jupiter on the zodiac' and 'the name of a year of 12 $D{\grave{i}}zh{\bar{i}}s$(地支) marks' accord with each other just for about 85 years, and it has been verified that recent dozens of years are the very period. In addition, appropriate methods of observing the the twenty-eight lunar mansions were elucidated. As $G{\bar{a}}nzh{\bar{i}}$(干支) almanac is related to the theoretical foundation of traditional medical practice as well as various techniques of future prediction, in-depth study on the fundamental theory of ancient $Ti{\bar{a}}nt{\check{i}}l{\grave{i}}$(天體曆) cannot be neglected for the succession and development of traditional oriental study and culture, too.

• The Journal of Korean Society for Radiation Therapy
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• v.32
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• pp.17-29
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• 2020

Purpose: The purpose of this work was to investigate the dosimetric impact of mixed energy partial arc technique on prostate cancer VMAT. Materials and Methods: This study involved prostate only patients planned with 70Gy in 30 fractions to the planning target volume (PTV). Femoral heads, Bladder and Rectum were considered as oragan at risk (OARs). For this study, mixed energy partial arcs (MEPA) were generated with gantry angle set to 180°~230°, 310°~50° for 6MV arc and 130°~50°, 310°~230° for 15MV arc. Each arc set the avoidance sector which is gantry angle 230°~310°, 50°~130° at first arc and 50°~310° at second arc. After that, two plans were summed and were analyzed the dosimetry parameter of each structure such as Maximum dose, Mean dose, D2%, Homogeneity index (HI) and Conformity Index (CI) for PTV and Maximum dose, Mean dose, V70Gy, V50Gy, V30Gy, and V20Gy for OARs and Monitor Unit (MU) with 6MV 1 ARC, 6MV, 10MV, 15MV 2 ARC plan. Results: In MEPA, the maximum dose, mean dose and D2% were lower than 6MV 1 ARC plan(p<0.0005). However, the average difference of maximum dose was 0.24%, 0.39%, 0.60% (p<0.450, 0.321, 0.139) higher than 6MV, 10MV, 15MV 2 ARC plan, respectively and D2% was 0.42%, 0.49%, 0.59% (p<0.073, 0.087, 0.033) higher than compared plans. The average difference of mean dose was 0.09% lower than 10MV 2 ARC plan, but it is 0.27%, 0.12% (p<0.184, 0.521) higher than 6MV 2 ARC, 15MV 2 ARC plan, respectively. HI was 0.064±0.006 which is the lowest value (p<0.005, 0.357, 0.273, 0.801) among the all plans. For CI, there was no significant differences which were 1.12±0.038 in MEPA, 1.12±0.036, 1.11±0.024, 1.11±0.030, 1.12±0.027 in 6MV 1 ARC, 6MV, 10MV, 15MV 2 ARC, respectively. MEPA produced significantly lower rectum dose. Especially, V70Gy, V50Gy, V30Gy, V20Gy were 3.40, 16.79, 37.86, 48.09 that were lower than other plans. For bladder dose, V30Gy, V20Gy were lower than other plans. However, the mean dose of both femoral head were 9.69±2.93, 9.88±2.5 which were 2.8Gy~3.28Gy higher than other plans. The mean MU of MEPA were 19.53% lower than 6MV 1 ARC, 5.7% lower than 10MV 2 ARC respectively. Conclusion: This study for prostate radiotherapy demonstrated that a choice of MEPA VMAT has the potential to minimize doses to OARs and improve homogeneity to PTV at the expense of a moderate increase in maximum and mean dose to the femoral heads.