Fig. 3. An example of radiation dose distribution of 6,600 cGy or cGyRBE in 10 fractions for the patient with centrally located hepatocellular carcinoma invading the inferior vena cava according to radiation therapy techniques. (A) Volumetric modulated arc therapy (VMAT); (B) proton beam therapy (PBT) with pencil-beam technique; (C) comparison of dose-volume histograms (DVHs) for VMAT (dot lines) and PBT (solid lines). The orange and sky-blue lines represent the DVHs for gross tumor volume, and clinical target volume, respectively. The yellow and red lines represent the DVHs for esophagogastric junction and liver, respectively. The irradiated area in the liver parenchyma is significantly smaller in the PBT plan (B) comparing with VMAT plan (A). The DVH shows that the irradiation in the liver and esophagogastric junction is higher in the VMAT plan comparing with PBT (C).
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