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. 2023 Mar 29;8(6):101226. doi: 10.1016/j.adro.2023.101226

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© 2023 The Author(s)

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

PMC Copyright notice

Computed tomography–guided stereotactic adaptive radiation therapy and nonadaptive plans. In this plan, which is projected on an ETHOS kv CBCT, a part of the proximal bronchial tree (yellow) is within the tumor, which can introduce significant challenge when treating ultracentral thoracic disease with SBRT. Here, minor changes in anatomy and rotation between simulation and treatment would have led to overdosing (≥50 Gy) of the proximal bronchial tree in the P_I (A) which was resolved in the P_A (B), all while maintaining GTV (red) and PTV (cyan) coverage. The dose to proximal bronchial tree, GTV, and PTV are represented in the DVH for both the P_I (squares) and P_A (triangles). Abbreviations: CBCT = cone-beam computed tomography; DVH = dose-volume histogram; GTV = gross tumor volume; PTV = planning target volume; SBRT = stereotactic body radiation therapy.