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Conclusion: IMPT provided improved PTV dose coverage than BT especially when the HR-CTV was very asymmetrical. However, IMPT delivered higher doses to OARs, especially the sigmoid, when all OARs were surrounding the target. Bone marrow received two to three times fractional dose higher comparing IMRT to BT. Although the MFO technique could create comparable plan to BT when a small margin is applied, it can increase the risk of late complications to the sigmoid and hematologic toxicity to the bone marrow.

No abstract