As tumor shows substantial shrinkage over the course of treatment, should radiation treatment volume be adjusted? A quantitative method using “radial distance”- the distance from the outer boundary of the tumor to the center of the rectum, was developed to evaluate the gross tumor volume (GTV) delineated on MRI acquired before treatment and after 3-4 weeks of radiation. In 35 patients, the mean tumor volume decreased from 19.1 to 10.5 cm3 but the mean radial distance only decreased slightly from 16.3 to 15.6 mm. When the remaining tumor was close to the rectal wall, the PTV should not be adjusted.
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