Fig. 1

Comparison of 3D-CRT vs. IMRT-treatment planning, shown for one patient with stage IIIA NSCLC in the left hilum. a IF-RT planning with treatment volume: FDG-PET based PTV (red, colorwash). With IMRT planning (second row) administration of a total dose of 78 Gy would be possible vs. 72 Gy with 3D-CRT (first row). Mean lung dose was dose limiting both in 3D-CRT and IMRT (see dose-volume-histogram (DVH)). b Example for atlas-based individual delineation of single thoracic lymph node stations (first row) according to Chapet et al. [15]. Out-of-field lymph node stations were subsequently merged to two regions of interest: first, LN_{all_el}, i.e. all out-of-field lymph nodes stations (green, colorwash), and second, LN_{adj_el}, i.e. uninvolved lymph node stations 7 and 10/11 (ipsilateral) or anatomically adjacent to involved lymph node stations (pink line). The DVH reveals a lower dose exposition for both sets of out-of-field lymph node stations for two IMRT-plans (with or without additional dose escalation (IMRT and IMRT_norm, respectively) as opposed to 3D-CRT