1) Adaptative radiation therapy after surgery for gastric-esophageal carcinoma

HISTORY Patient 54 years old with ulcerated gastric carcinoma (mucinous adenocarcinoma G2 pT3 pN0 pMx 3.5 cm.full wall infiltrating) treated with total gastrectomy and chemotherapy (3 cycle CDDP+5FU+EPI).
RADIATION THERAPY DISTRIBUTION DOSE
It was planned treatment with adaptative radiation therapy (RT with LINAC 15MV).
The planning was organized with three fields: front, right rear oblique field and left rear oblique field.
It was planned and carried out with a daily dose of 1.8Gy and final dose of 45 Gy.


A coronal: location of intra-thoracic esophageal-jejunal anastomosis (red arrows)
B coronal: volume planning of the area to be treat (pink color)
C coronal: area to be treat with their isodose curves
D sagittal: location of intra-thoracic esophageal-jejunal anastomosis (red arrows)
E sagittal: volume planning of the area to be treat (pink color)
F sagittal: area to be treat with their isodose curves
G axial: start bordering of the area to be treat (red line) and the area to be exclude (light blue line)
H: graphic depiction of the isodose curves. Best chance of rapid dose attenuation in critical organs. Sufficiently constant dose on the target to be treat
I axial: end bordering of the entire area to be treat (red line) and the entire area to be exclude (light blue line)