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STRATEGY \ PTV Margins: 5 mm
3 mm
0 mm
IGRT alone
No Adaptation
OK
-
-
IGRT with midcourse
New Plan without
Accumulated Dose
OK
OK?
-
IMRT with weekly
Explicit
Adaptation with
Accumulated Dose
OK
OK
OK?
Relationship to PTV Margins
Maximize NT Sparing
Increasing Effort/Complexity