Adaptation requirements due to anatomical changes in free-breathing and deep-inspiration breath-hold for standard and dose-escalated radiotherapy of lung cancer patients

Figures & data

Figure 1. Examples of simulated anatomical changes: a) 3 cm pleural effusion for the centrally located tumor in the CIRS thorax phantom, b) 3 cm pleural effusion in a patient, c) tumor shrinkage in the form of 1 cm radius reduction in a patient, and d) large atelectasis disappearance between pre-treatment (upper) and post-treatment (lower) CT. Colors available online.

Figure 2. Impact of pleural effusion (upper row) and tumor shrinkage (lower row) on Dmax to the spinal cord as well as <D>_GTV-T <D>_CTV-T and <D>_PTV-T for simulations carried out in a CIRS dynamic thorax phantom (locations: A, anterior; C, central; P, posterior).

Figure 3. Impact of pleural effusion on <D>_GTV-T for all 16 patients and combinations of scanning technique and fractionation.

Figure 4. Impact of tumor shrinkage on <D>_GTV-T for all 16 patients and combinations of scanning technique and fractionation.