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. 2020 Feb;11(1):144–156. doi: 10.21037/jgo.2019.11.04

Figure 1.

Figure 1

Pencil beam scanning proton therapy (PBS-PBT, A,B,C) and intensity modulated photon radiotherapy (IMRT, D,E,F) plans for a patient with clinical T2N1M0 adenocarcinoma of the distal esophagus treated with neoadjuvant chemoradiotherapy. The prescribed dose is 50 Gy to the high-risk clinical target volume (gross tumor volume + 1 cm) and 45 Gy to the low-risk clinical target volume (elective gastroesophageal mucosa and regional lymph nodes), delivered in 25 fractions. Note similar distribution of the high-dose volume (50–45 Gy, red and orange), but substantial reduction in the moderate-low dose (30–5 Gy, green and blue) with PBS-PBT vs. IMRT. Notably, there is significant reduction in dose to the heart and lungs with PBS-PBT vs. IMRT.