Defining the Optimal Time of Adaptive Replanning in Prostate Cancer Patients with Weight Change during Volumetric Arc Radiotherapy: A Dosimetric and Mathematical Analysis Using the Gamma Index

<div>The changes in dosimetric parameters (a) rectum <svg height="14.1238pt" id="M60" style="vertical-align:-5.487901pt" version="1.1" viewbox="-0.0498162 -8.6359 29.3949 14.1238" width="29.3949pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M697 650H468L461 623L492 619C539 613 547 605 518 546C481 471 367 264 278 116H276C239 278 197 500 186 567C180 604 185 613 226 619L252 623L260 650H24L17 623C78 617 92 613 108 533L216 -11H247C365 200 515 462 560 529C616 612 624 615 689 623L697 650Z" id="g113-87"></path></g><g transform="matrix(.0091,0,0,-0.0091,7.332,3.132)"><path d="M453 623H65C60 580 56 530 46 472H80C103 538 110 548 175 548H389C310 380 195 168 90 0L98 -12L175 -2C273 206 366 408 462 610L453 623Z" id="g50-56"></path></g><g transform="matrix(.0091,0,0,-0.0091,11.765,3.132)"><path d="M245 635C92 635 37 457 37 312C37 149 91 -12 244 -12C395 -12 449 166 449 312C449 469 395 635 245 635ZM243 598C332 598 358 454 358 312C358 173 334 26 245 26C158 26 128 174 128 313S152 598 243 598Z" id="g50-49"></path></g><g transform="matrix(.0091,0,0,-0.0091,17.741,3.132)"><path d="M700 305H441V272C542 264 548 258 548 186V107C548 64 536 53 516 42C493 30 462 24 429 24C237 24 151 189 151 333C151 517 264 626 415 626C507 626 585 594 609 470L642 476C634 544 629 601 626 636C594 644 513 665 429 665C234 665 46 554 46 321C46 123 194 -15 415 -15C495 -15 578 7 642 22C635 50 635 81 635 116V201C635 259 639 264 700 272V305Z" id="g58-69"></path></g><g transform="matrix(.0091,0,0,-0.0091,24.256,3.132)"><path d="M488 439H302V409C359 401 366 390 354 354C333 287 289 177 262 107L171 356C158 391 163 402 210 409L209 439H3V409C59 401 68 388 90 336C119 267 164 144 204 31C211 16 211 0 206 -15C202 -27 195 -48 176 -81C153 -124 134 -146 102 -166C85 -177 77 -187 77 -203C77 -228 107 -253 136 -253C151 -253 164 -248 169 -228C185 -175 203 -120 273 41C342 204 375 284 399 337C425 392 435 401 488 409V439Z" id="g58-119"></path></g></svg> and (b) bladder <svg height="14.1238pt" id="M61" style="vertical-align:-5.487901pt" version="1.1" viewbox="-0.0498162 -8.6359 29.3949 14.1238" width="29.3949pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><path d="M697 650H468L461 623L492 619C539 613 547 605 518 546C481 471 367 264 278 116H276C239 278 197 500 186 567C180 604 185 613 226 619L252 623L260 650H24L17 623C78 617 92 613 108 533L216 -11H247C365 200 515 462 560 529C616 612 624 615 689 623L697 650Z" id="g113-87"></path></g><g transform="matrix(.0091,0,0,-0.0091,7.332,3.132)"><path d="M453 623H65C60 580 56 530 46 472H80C103 538 110 548 175 548H389C310 380 195 168 90 0L98 -12L175 -2C273 206 366 408 462 610L453 623Z" id="g50-56"></path></g><g transform="matrix(.0091,0,0,-0.0091,11.765,3.132)"><path d="M245 635C92 635 37 457 37 312C37 149 91 -12 244 -12C395 -12 449 166 449 312C449 469 395 635 245 635ZM243 598C332 598 358 454 358 312C358 173 334 26 245 26C158 26 128 174 128 313S152 598 243 598Z" id="g50-49"></path></g><g transform="matrix(.0091,0,0,-0.0091,17.741,3.132)"><path d="M700 305H441V272C542 264 548 258 548 186V107C548 64 536 53 516 42C493 30 462 24 429 24C237 24 151 189 151 333C151 517 264 626 415 626C507 626 585 594 609 470L642 476C634 544 629 601 626 636C594 644 513 665 429 665C234 665 46 554 46 321C46 123 194 -15 415 -15C495 -15 578 7 642 22C635 50 635 81 635 116V201C635 259 639 264 700 272V305Z" id="g58-69"></path></g><g transform="matrix(.0091,0,0,-0.0091,24.256,3.132)"><path d="M488 439H302V409C359 401 366 390 354 354C333 287 289 177 262 107L171 356C158 391 163 402 210 409L209 439H3V409C59 401 68 388 90 336C119 267 164 144 204 31C211 16 211 0 206 -15C202 -27 195 -48 176 -81C153 -124 134 -146 102 -166C85 -177 77 -187 77 -203C77 -228 107 -253 136 -253C151 -253 164 -248 169 -228C185 -175 203 -120 273 41C342 204 375 284 399 337C425 392 435 401 488 409V439Z" id="g58-119"></path></g></svg> with changes in body contour from −2.0 cm to 2.0 cm for different photon energy levels.</div>

Computational and Mathematical Methods in Medicine

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Figure 5

Figure 5: Defining the Optimal Time of Adaptive Replanning in Prostate Cancer Patients with Weight Change during Volumetric Arc Radiotherapy: A Dosimetric and Mathematical Analysis Using the Gamma Index 

Figure 5 | Defining the Optimal Time of Adaptive Replanning in Prostate Cancer Patients with Weight Change during Volumetric Arc Radiotherapy: A Dosimetric and Mathematical Analysis Using the Gamma Index 