Fig. 4

Case example of intrafractional changes to OAR dose. The duodenum dose constraint was met in the adapted dose distribution (a), but intrafractional organ movement caused a constraint violation in the pre-irradiation dose distribution (b). In another fraction of the same patient, the duodenum constraint was met in both, the adapted (c) and the pre-irradiation dose distribution (d). The duodenum is depicted in orange, the GTV in green and the PTV in red. The duodenum D0.5cc dose constraint for this prescription is at 35 Gy