Volumetric Modulated Arc Therapy of the Pelvic Lymph Nodes to the Aortic Bifurcation in Higher Risk Prostate Cancer: Early Toxicity Outcomes

Figure 2

Dose distribution in adjuvant and salvage VMAT treatment. (a) Clinical target volumes: CTV 1 (orange) including presacral, common iliac, and para-aortic lymph nodes, left and right pelvic lymph nodes and prostate and seminal vesicles or prostatic fossa. CTV 2 (pink) including left and right pelvic lymph nodes and prostate and seminal vesicles or prostatic fossa. CTV 3 (red) including prostate and seminal vesicles or prostatic fossa. (b) Dose cloud superimposed on CTV 1: demonstrating dose of 49.5 Gy delivered to 95% of CTV 1 at 1.5 Gy per fraction for 33 fractions. (c) Simultaneous boost to 56.1 Gy: dose cloud superimposed on CTV 2 demonstrating dose of 56.1 Gy delivered to 95% of CTV 2 at 1.7 Gy per fraction for 33 fractions. (d) Simultaneous boost to 66 Gy: dose cloud superimposed on CTV 3 demonstrating dose of 66 Gy delivered to 95% of CTV 3 at 2 Gy per fraction for 33 fractions.

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