Fig. 3
Forward dose distribution of the optimized plan for the ITVG5 (white contour) in one of the weekly CTs. Different inter-fractional changes are disclosed for analysis of the CTV (blue) V95CTV: (a) Patient 3, for which the use of an anterior beam results in CTV under-dose due to changes in the bowel/stomach, (b) Patient 6, the oblique posterior beam does not overcome the tumor shift and deformation. c Patient 10, irradiation with a lateral right beam, where the range changes resulted from the bowel and liver position led to health tissues overdose. d Patient 8, an anterior beam is not robust to the accentuated weight loss (visible the comparison of the distribution in the first and last week CT). e Dose distribution for the same CT and patient as in the figure a) but showing the retrospectively determined ITVWEPL (black contour) in comparison to the ITVG5