Intensity-Modulated and Image-Guided Radiotherapy in Patients with Locally Advanced Inoperable Pancreatic Cancer after Preradiation Chemotherapy

Figure 1

Radiation plan. Representative dose distribution of a Tomotherapy plan for a pancreatic recurrency, given in three orthogonal planes: the dark red contour delineates the macroscopic tumor (ascertained by PET) with a prescribed dose of 64.5 Gy. The planning target volume (PTV) is light red and includes the adjacent lymph nodes. The prescribed dose is 51 Gy. Dose coverage of >95% is achieved. The surrounding normal tissues liver, kidneys (light blue), intestine (magenta), and spinal cord (orange) are particularly spared. In this patient only a small part of the intestine (<100 mL) is exposed to a dose > 30 Gy (blue region). Note the high conformality as well as the steep dose gradient from 60 below 30 Gy in selected directions.