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Duodenal toxicity in Extended field RT

• Limiting V55 to less than 15% - statistically

significant differences in 3 year rate of

actuarial duodenal toxicity

• IMRT allows sufficient sparing of the small

bowel to allow dose escalation to 65Gy

Verma et al; IJROBP 2014; 88: 357-362

Poorvu et al; IJROBP 2013; 85: 1262-8