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Discussion: Clinical Relevance

Replanning … when and on what volume?

Target size change and tumor-to-OAR distances should be considered

when deciding whether a lung SBRT patient would benefit from adaptive

treatment (Yujiao Qin et al.)

Do not start with replanning when implementing lung SBRT

Safety issues

The relation between fiducial markers and tumor may have changed

Check tumor position with respect to the organs at risk and adapt the

plan if organs at risk constraints are violated