Fig. 3

A representative patient with pancreatic adenocarcinoma who was initially planned to receive 50.4Gy in 28 fractions using a 4-field 3D conformal radiation plan (a-c). Unfortunately, he only received 43.2Gy in 24 fractions before having to stop capecitabine-based chemoradiation due to a family emergency. He was subsequently unable to undergo surgical resection due to anatomic unresectability. Thirteen months later, he developed isolated local progression and was treated to a total dose of 30Gy in 20, twice-daily fractions of 1.5Gy each using an intensity-modulated radiation therapy technique (d-f). He received concurrent oral capecitabine chemotherapy. The cumulate plan is shown (g-i)