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@ARTICLE{Kessel:128883,
      author       = {K. A. Kessel and A. Jäger$^*$ and D. Habermehl and J.
                      Rüppell$^*$ and R. Bendl$^*$ and J. Debus$^*$ and S. E.
                      Combs},
      title        = {{C}hanges in {G}ross {T}umor {V}olume and {O}rgan {M}otion
                      {A}nalysis {D}uring {N}eoadjuvant {R}adiochemotherapy in
                      {P}atients {W}ith {L}ocally {A}dvanced {P}ancreatic {C}ancer
                      {U}sing an {I}n-{H}ouse {A}nalysis {S}ystem.},
      journal      = {Technology in cancer research $\&$ treatment},
      volume       = {15},
      number       = {2},
      issn         = {1533-0338},
      address      = {[Thousand Oaks, CA]},
      publisher    = {Sage},
      reportid     = {DKFZ-2017-04896},
      pages        = {348 - 354},
      year         = {2016},
      abstract     = {During radiation treatment, movement of the target and
                      organs at risks as well as tumor response can significantly
                      influence dose distribution. This is highly relevant in
                      patients with pancreatic cancer, where organs at risk lie in
                      close proximity to the target.Data sets of 10 patients with
                      locally advanced pancreatic cancer were evaluated. Gross
                      tumor volume deformation was analyzed. Dose changes to
                      organs at risk were determined with focus on kidneys both
                      without adaptive radiotherapy compensation and with
                      replanning based on weekly acquired computed tomography
                      scans.During irradiation, gross tumor volume changes between
                      $0\%$ and $26\%$ and moves within a radius of 5 to 16 mm.
                      Required maximal dose to organs at risk for kidneys can be
                      met with the current practice of matching computed
                      tomography scans during treatment and adjusting patient
                      position accordingly. Comparison of the mean doses and V15,
                      V20 volumes demonstrated that weekly replanning could bring
                      a significant dose sparing of the left kidney.Manual
                      matching with focus on bony structures can lead to overall
                      acceptable positioning of patients during treatment. Thus,
                      tolerance doses of organs at risk, such as the kidneys, can
                      be met. With adequate margins, normal tissue constraints to
                      organs at risk can be kept as well. Adaptive radiotherapy
                      approaches (in this case with weekly rescanning) reduced
                      dose to organs at risk, which may be especially important
                      for hypofractionated approaches.},
      cin          = {E071 / E040 / E050},
      ddc          = {610},
      cid          = {I:(DE-He78)E071-20160331 / I:(DE-He78)E040-20160331 /
                      I:(DE-He78)E050-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:25824268},
      doi          = {10.1177/1533034615577515},
      url          = {https://inrepo02.dkfz.de/record/128883},
}