case_images: PMC5304382_01
case_images: CT sagittal view of the patient's pelvis before EBRT (anteverted position of the uterus)
case_images: JMedLife-10-90-g001.jpg
case_images: PMC5304382_01_JMedLife-10-90-g001.jpg
case_images: F1
case_images: The patient underwent a thorax-abdominal-pelvic CT scan that identified an anteverted uterus (Fig. 1), presenting a large tumoral mass, without a well-defined border with the rectum and the urinary bladder.
case_images: EBRT target volumes contoured according to ICRU62 recommendations (CTV-red, ITV-green, PTV-violet) and their relationship with the rectum (brown) and urinary bladder (yellow)
case_images: JMedLife-10-90-g002.jpg
case_images: PMC5304382_01_JMedLife-10-90-g002.jpg
case_images: F2
case_images: Protocol [] recommendations; therefore, the internal target volumes (ITV) were obtained for both CTV's by adding a 1 cm internal margin (IM) into the urinary bladder. Planning target volumes (PTV), PTV_45 and PTV_54 resulted by adding a 0.5 cm margin around the ITV_45 and ITV_54 respectively (Fig. 2).
case_images: EBRT treatment planning by using the 7-field IMRT technique
case_images: JMedLife-10-90-g003.jpg
case_images: PMC5304382_01_JMedLife-10-90-g003.jpg
case_images: F3
case_images: Radiotherapy planning was performed by using the inverse planning approach and xiO planning system, resulting in a 7-field treatment (Fig. 3).
case_images: MRI sagittal view of the pelvis of the patient at the end of EBRT (retroverted position of the uterus)
case_images: JMedLife-10-90-g004.jpg
case_images: PMC5304382_01_JMedLife-10-90-g004.jpg
case_images: F4
case_images: This identified a significant reduction of more than 50% of the tumor mass, but also a change of the local anatomy, the uterus being retroverted (Fig. 4).