{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T06:01:00Z","timestamp":1784959260584,"version":"3.55.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We examined factors associated with acute radiation-induced nocturia (ARIN) in patients with localized prostate cancer (LPC) treated with proton beam therapy (PBT). We included 140 patients who underwent PBT for LPC. Of these, 80 patients with implanted hydrogel spacers were treated with moderately hypo-fractionated proton therapy (MHPT) (60\u201366 GyRBE in 20\u201322 fractions) and 60 patients without hydrogel spacers were treated with normo-fractionated proton therapy (NFPT) (74\u201378 GyRBE in 37\u201339 fractions). In-room computed tomography was performed for each fraction to monitor target position. Prostate\u2013rectum boundary matching was adopted to effectively reduce rectal dose, and position translation and pitch angle corrections were performed depending on rectal filling changes. ARIN was evaluated based on the nocturnal voiding frequencies. We first performed multivariate logistic regression (MLR) analysis to identify significant factors for ARIN. Subsequently, propensity score matching (PSM) was performed as a sensitivity analysis to address potential confounding and to assess the robustness of the findings. The analyses showed that 45\/140 patients experienced ARIN during\/immediately after PBT. MLR analysis showed that \u2018treatment regimen\u2019 (MHPT with spacer vs NFPT without spacer) was statistically significantly associated with ARIN (OR: 0.25, 95% CI: 0.09\u20130.67, P\u2009&amp;lt;\u20090.05). This association remained significant after PSM. In conclusion, while \u2018treatment regimen\u2019 was statistically associated with ARIN, this finding should be interpreted cautiously as reflecting a composite treatment strategy within the limitations of a retrospective analysis, rather than a causal relationship.<\/jats:p>","DOI":"10.1093\/jrr\/rrag044","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T11:39:57Z","timestamp":1779536397000},"page":"648-655","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with acute radiation-induced nocturia in localized prostate cancer treated with proton beam therapy"],"prefix":"10.1093","volume":"67","author":[{"given":"Keita","family":"Yoshizaki","sequence":"first","affiliation":[{"name":"Department of Radiology, Kouseikai Takai Hospital , 470-8, Kuranosho-cho, Tenri-shi, Nara 632-0006 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoji","family":"Tabata","sequence":"additional","affiliation":[{"name":"Department of Radiology, Nara Prefecture General Medical Center , 2-897-5, Shichijou-nishi, Nara-shi, Nara 630-8581 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Yoshioka","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kouseikai Takai Hospital , 470-8, Kuranosho-cho, Tenri-shi, Nara 632-0006 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryosaku","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kouseikai Takai Hospital , 470-8, Kuranosho-cho, Tenri-shi, Nara 632-0006 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Azuma","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kouseikai Takai Hospital , 470-8, Kuranosho-cho, Tenri-shi, Nara 632-0006 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kouseikai Takai Hospital , 470-8, Kuranosho-cho, Tenri-shi, Nara 632-0006 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Department of Radiology, Kouseikai Takai Hospital , 470-8, Kuranosho-cho, Tenri-shi, Nara 632-0006 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"2026072501212849700_ref1","volume-title":"Global Cancer Observatory: CANCER TODAY (GLOBOCAN) 2022: Japan","author":"International Agency for Research on Cancer"},{"key":"2026072501212849700_ref2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.3892\/mco.2022.2599","article-title":"Population-based prostate-specific antigen screening for prostate cancer may have an indirect effect on early detection through opportunistic testing in Kusatsu City, Shiga","volume":"18","author":"Kageyama","year":"2022","journal-title":"Jpn Mol Clin Oncol"},{"key":"2026072501212849700_ref3","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1007\/s10654-017-0292-5","article-title":"A randomized trial of early detection of clinically significant prostate cancer (ProScreen): study design and rationale","volume":"32","author":"Auvinen","year":"2017","journal-title":"Eur J Epidemiol"},{"key":"2026072501212849700_ref4","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.adro.2016.10.005","article-title":"Urinary quality of life outcomes in men who were treated with image-guided intensity-modulated radiation therapy for prostate cancer","volume":"1","author":"Salami","year":"2016","journal-title":"Adv Radiat Oncol"},{"key":"2026072501212849700_ref5","doi-asserted-by":"publisher","first-page":"20160877","DOI":"10.1259\/bjr.20160877","article-title":"Prospective evaluation of a specific technique of sexual function preservation in external beam radiotherapy for prostate cancer","volume":"90","author":"Samlali","year":"2017","journal-title":"Br J Radiol"},{"key":"2026072501212849700_ref6","doi-asserted-by":"publisher","first-page":"1681","DOI":"10.1016\/j.ejmp.2016.08.013","article-title":"Bladder spatial-dose descriptors correlate with acute urinary toxicity after radiation therapy for prostate cancer","volume":"32","author":"Improta","year":"2016","journal-title":"Eur J Med Phys"},{"key":"2026072501212849700_ref7","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1016\/j.ijrobp.2005.02.015","article-title":"Acute genitourinary toxicity after high dose rate (HDR) brachytherapy combined with hypofractionated external-beam radiation therapy for localized prostate cancer: second analysis to determine the correlation between the urethral dose in HDR brachytherapy and the severity of acute genitourinary toxicity","volume":"63","author":"Akimoto","year":"2005","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2026072501212849700_ref8","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.radonc.2021.12.027","article-title":"Urethral and bladder dose\u2013effect relations for late genitourinary toxicity following external beam radiotherapy for prostate cancer in the FLAME trial","volume":"167","author":"Groen","year":"2022","journal-title":"Radiother Oncol"},{"key":"2026072501212849700_ref9","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.3390\/cancers14061365","article-title":"Substantial sparing of organs at risk with modern proton therapy in lung cancer, but altered breathing patterns can jeopardize target coverage","volume":"14","author":"Boer","year":"2022","journal-title":"Cancers (Basel)"},{"key":"2026072501212849700_ref10","doi-asserted-by":"publisher","first-page":"403","DOI":"10.3390\/cancers16020403","article-title":"Dosimetric comparison study of proton therapy using line scanning versus passive scattering and volumetric modulated arc therapy for localized prostate cancer","volume":"16","author":"Takagi","year":"2024","journal-title":"Cancers (Basel)"},{"key":"2026072501212849700_ref11","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1002\/cam4.607","article-title":"Preliminary treatment results of proton beam therapy with chemoradiotherapy for stage I-III esophageal cancer","volume":"5","author":"Takada","year":"2016","journal-title":"Cancer Med"},{"key":"2026072501212849700_ref12","article-title":"Evidence brief: proton beam therapy for treatment of localized prostate cancer. Washington DC: Evidence Synthesis Program, Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs. VA ESP Project #09-199; 2022.","author":"Hickam"},{"key":"2026072501212849700_ref13","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1002\/cncr.28536","article-title":"Comparative effectiveness study of patient-reported outcomes following proton therapy or IMRT for prostate cancer","volume":"120","author":"Hoppe","year":"2014","journal-title":"Cancer"},{"key":"2026072501212849700_ref14","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1093\/jjco\/hyaa027","article-title":"Health-related quality of life in Japanese patients with prostate cancer following proton beam therapy: an institutional cohort study","volume":"50","author":"Matsukawa","year":"2020","journal-title":"Jpn J Clin Oncol"},{"key":"2026072501212849700_ref15","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1111\/iju.14102","article-title":"Quality of life in prostate cancer patients receiving particle radiotherapy: a review of the literature","volume":"27","author":"Kawamura","year":"2020","journal-title":"Int J Urol"},{"key":"2026072501212849700_ref16","doi-asserted-by":"publisher","first-page":"430.e1","DOI":"10.1016\/j.urolonc.2016.04.015","article-title":"Acute and late urinary toxicity following radiation in men with an intact prostate gland or after a radical prostatectomy: a secondary analysis of RTOG 94-08 and 96-01","volume":"34","author":"Mak","year":"2016","journal-title":"Urol Oncol"},{"key":"2026072501212849700_ref17","doi-asserted-by":"publisher","first-page":"24","DOI":"10.5603\/RPOR.a2023.0015","article-title":"Relationship between changes in quality of life and genitourinary toxicity grade after brachytherapy with I-125 alone for localised prostate cancer","volume":"28","author":"Hashimoto","year":"2023","journal-title":"Rep Pract Oncol Radiother"},{"key":"2026072501212849700_ref18","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1016\/j.clon.2016.04.041","article-title":"Acute and late genitourinary toxicity after 72 Gy of conventionally fractionated conformal radiotherapy for localised prostate cancer: impact of individual and clinical parameters","volume":"28","author":"Stankovic","year":"2016","journal-title":"Clin Oncol (R Coll Radiol)"},{"key":"2026072501212849700_ref19","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1016\/j.ijrobp.2012.02.061","article-title":"Acute radiation-induced nocturia in prostate cancer patients is associated with Pretreatment symptoms, radical prostatectomy, and genetic markers in the TGF\u03b21 gene","volume":"85","author":"Langhe","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2026072501212849700_ref20","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1080\/13696998.2016.1211136","article-title":"Assessing the impact of nocturia on health-related quality-of-life and utility: results of an observational survey in adults","volume":"19","author":"Andersson","year":"2016","journal-title":"J Med Econ"},{"key":"2026072501212849700_ref21","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/j.prro.2016.05.007","article-title":"Optimal bladder volume at treatment planning for prostate cancer patients receiving volumetric modulated arc therapy","volume":"6","author":"Fujioka","year":"2016","journal-title":"Pract Radiat Oncol"},{"key":"2026072501212849700_ref22","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1186\/s13014-016-0681-z","article-title":"Dosimetric impact of different bladder and rectum filling during prostate cancer radiotherapy","volume":"11","author":"Chen","year":"2016","journal-title":"Radiat Oncol"},{"key":"2026072501212849700_ref23","doi-asserted-by":"publisher","first-page":"e329","DOI":"10.1016\/j.ijrobp.2011.05.011","article-title":"A beam-specific planning target volume (PTV) design for proton therapy to account for setup and range uncertainties","volume":"82","author":"Park","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2026072501212849700_ref24","doi-asserted-by":"publisher","first-page":"1832","DOI":"10.1002\/mp.12858","article-title":"Positioning accuracy and daily dose assessment for prostate cancer treatment using in-room CT image guidance at a proton therapy facility","volume":"45","author":"Maeda","year":"2018","journal-title":"Med Phys"},{"key":"2026072501212849700_ref25","doi-asserted-by":"publisher","first-page":"1844","DOI":"10.1002\/mp.12869","article-title":"Effects of organ motion on proton prostate treatments, as determined from analysis of daily CT imaging for patient positioning","volume":"45","author":"Maeda","year":"2018","journal-title":"Med Phys"},{"key":"2026072501212849700_ref26","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1002\/acm2.13015","article-title":"Stability of daily rectal movement and effectiveness of replanning protocols for sparing rectal doses based on the daily CT images during proton treatment for prostate cancer","volume":"21","author":"Maeda","year":"2020","journal-title":"J Appl Clin Med Phys"},{"key":"2026072501212849700_ref27","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1016\/j.ijrobp.2004.04.017","article-title":"Intensity-modulated radiotherapy as primary treatment for prostate cancer: acute toxicity in 114 patients","volume":"60","author":"Meerleer","year":"2004","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2026072501212849700_ref28","volume-title":"Version 4.3.1. R Foundation for Statistical Computing","author":"R Development Core Team","year":"2023"},{"key":"2026072501212849700_ref29","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1038\/bmt.2012.244","article-title":"Investigation of the freely available easy-to-use software 'EZR' for medical statistics","volume":"48","author":"Kanda","year":"2013","journal-title":"Bone Marrow Transplant"},{"key":"2026072501212849700_ref30","doi-asserted-by":"publisher","first-page":"280","DOI":"10.1093\/aje\/kwg115","article-title":"Comparison of logistic regression versus propensity score when the number of events is low and there are multiple confounders","volume":"158","author":"Cepeda","year":"2003","journal-title":"Am J Epidemiol"},{"key":"2026072501212849700_ref31","doi-asserted-by":"publisher","first-page":"136","DOI":"10.4172\/2155-6180.1000136","article-title":"Nonparametric diagnostic test for conditional logistic regression","volume":"3","author":"Goodman","year":"2012","journal-title":"J Biom Biostat"},{"key":"2026072501212849700_ref32","doi-asserted-by":"publisher","first-page":"57","DOI":"10.3389\/fpubh.2018.00057","article-title":"Unconditional or conditional logistic regression model for age-matched case\u2013control data?","volume":"6","author":"Kuo","year":"2018","journal-title":"Front Public Health"},{"key":"2026072501212849700_ref33","doi-asserted-by":"publisher","first-page":"900681","DOI":"10.3389\/fmicb.2022.900681","article-title":"Risk factors of severe Clostridioides difficile infection; sequential organ failure assessment score, antibiotics, and Ribotypes","volume":"13","author":"Choi","year":"2022","journal-title":"Front Public Health"},{"key":"2026072501212849700_ref34","doi-asserted-by":"publisher","first-page":"1096","DOI":"10.21037\/tcr-20-2589","article-title":"Urological complications after radiation therapy - nothing ventured, nothing gained: a narrative review. Transl","volume":"10","author":"Chorbi\u0144ska","year":"2021","journal-title":"Cancer Res"},{"key":"2026072501212849700_ref35","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1186\/s13014-014-0275-6","article-title":"Hypofractionated radiotherapy for prostate cancer","volume":"9","author":"Hegemann","year":"2014","journal-title":"Radiat Oncol"},{"key":"2026072501212849700_ref36","doi-asserted-by":"publisher","first-page":"781340","DOI":"10.1155\/2014\/781340","article-title":"Hypofractionation in prostate cancer: radiobiological basis and clinical appliance","volume":"2014","author":"Mangoni","year":"2014","journal-title":"Biomed Res Int"},{"key":"2026072501212849700_ref37","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1093\/jjco\/hyad005","article-title":"Acute genitourinary toxicity of pencil beam scanning proton therapy for localized prostate cancer: utility of the transition zone index and average urinary flow rate in predicting acute urinary retention","volume":"53","author":"Takaoka","year":"2023","journal-title":"Jpn J Clin Oncol"},{"key":"2026072501212849700_ref38","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1007\/s00066-018-1398-8","article-title":"Impact of bladder volume on acute genitourinary toxicity in intensity modulated radiotherapy for localized and locally advanced prostate cancer","volume":"195","author":"Gr\u00fcn","year":"2019","journal-title":"Strahlenther Onkol"},{"key":"2026072501212849700_ref39","doi-asserted-by":"publisher","first-page":"100805","DOI":"10.1016\/j.adro.2021.100805","article-title":"Effect of large prostate volume on efficacy and toxicity of moderately hypofractionated radiation therapy in patients with prostate cancer","volume":"7","author":"Natesan","year":"2022","journal-title":"Adv Radiat Oncol"},{"key":"2026072501212849700_ref40","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.ijrobp.2007.05.051","article-title":"Toxicity profile with a large prostate volume after external beam radiotherapy for localized prostate cancer","volume":"70","author":"Pinkawa","year":"2008","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2026072501212849700_ref41","doi-asserted-by":"publisher","first-page":"1533033821995277","DOI":"10.1177\/1533033821995277","article-title":"BladderScan feedback method in predicting bladder filling for prostate radiotherapy: a prospective study","volume":"20","author":"Kuo","year":"2021","journal-title":"Technol Cancer Res Treat"},{"key":"2026072501212849700_ref42","article-title":"Overactive bladder training","author":"Royal Berkshire NHS Foundation Trust leaflet","year":"2025"},{"key":"2026072501212849700_ref43","doi-asserted-by":"publisher","first-page":"R419","DOI":"10.1088\/0031-9155\/59\/22\/R419","article-title":"Relative biological effectiveness (RBE) values for proton beam therapy. Variations as a function of biological endpoint, dose, and linear energy transfer","volume":"59","author":"Paganetti","year":"2014","journal-title":"Phys Med Biol"},{"key":"2026072501212849700_ref44","doi-asserted-by":"publisher","first-page":"05RM01","DOI":"10.1088\/1361-6560\/abcd16","article-title":"Roadmap: proton therapy physics and biology","volume":"66","author":"Paganetti","year":"2021","journal-title":"Phys Med Biol"},{"key":"2026072501212849700_ref45","doi-asserted-by":"publisher","first-page":"225009","DOI":"10.1088\/1361-6560\/aae8a5","article-title":"LET-weighted doses effectively reduce biological variability in proton radiotherapy planning","volume":"63","author":"McMahon","year":"2018","journal-title":"Phys Med Biol"},{"key":"2026072501212849700_ref46","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/j.radonc.2016.11.001","article-title":"Clinical evidence of variable proton biological effectiveness in pediatric patients treated for ependymoma","volume":"121","author":"Peeler","year":"2016","journal-title":"Radiother Oncol"}],"container-title":["Journal of Radiation Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jrr\/article-pdf\/67\/4\/648\/68683363\/rrag044.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jrr\/article-pdf\/67\/4\/648\/68683363\/rrag044.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:21:33Z","timestamp":1784956893000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jrr\/article\/67\/4\/648\/8723659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":46,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,7,2]]},"published-print":{"date-parts":[[2026,7,24]]}},"URL":"https:\/\/doi.org\/10.1093\/jrr\/rrag044","relation":{},"ISSN":["0449-3060","1349-9157"],"issn-type":[{"value":"0449-3060","type":"print"},{"value":"1349-9157","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7]]},"published":{"date-parts":[[2026,7]]}}}