Patients underwent CT simulation in a supine position with a slide of 2.5 mm. All patients were immobilized using a vacuum-assisted body mold to recreate exact positioning during daily sessions. Target lesion was not readily identified on the CT simulation, and the planning data set was registered to a diagnostic contrast CT or PET-CT, using a mutual information algorithm from our in-house treatment system, to facilitate gross tumor volume (GTV) delineation. A 3–8 mm isotropic expansion was generated from GTV to obtain planning target volume (PTV). Organs at risk (OARs) were delineated depending on the target lesion location without margins. The treatment planning system was Eclipse 4.5.5 (Varian), and VMAT/IMRT technique on a 6-MV linear accelerator Varian were used for treatment. The dose of SBRT was converted to the biologically effective dose (BED) to compare different dose-fractionation schedules. The BED was calculated using the linear-quadratic model with α/β = 10 Gy for the tumor and α/β = 3 to the organs at risk. Dose schedules were chosen with the aim of delivering ablative treatments respecting dose constraints for OARs.
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