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Fig 1.

Image of immobilization and set-up.

Thermoplast masks were used for immobilization.

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Fig 2.

Body volume was measured using cone beam computed tomography.

The measurement range was 7.5 cm in the superior and inferior directions from the centre of the CBCT.

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Fig 3.

Schema of treatment procedure and calculation of body indices and set-up error.

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Table 1.

Patient characteristics.

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Fig 4.

Correlations between body weight variations and body volume variations.

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Table 2.

Descriptive statistics of inter- and intra-fractional variations.

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Table 3.

Correlations between body weight or body volume variations and inter-fractional variations.

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Table 4.

Correlations between body weight or body volume variations and intra-fractional variations.

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Table 5.

Correlations between body weight or body volume variations and absolute value of inter-fractional variations.

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Table 6.

Correlations between body weight or body volume variations and absolute value of intra-fractional variations.

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Fig 5.

(A) Receiver operating characteristic curve of intra-fractional variations (≥2 mm) of anterior-posterior and decrease of body weight or volume. (B) Receiver operating characteristic curve of intra-fractional variations (≥2 mm) of three-dimensional vector and decrease of body weight or volume. (C) Receiver operating characteristic curve of intra-fractional variations (≥2 mm) of any directions and decrease of body weight or volume.

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Table 7.

Results of receiver operating characteristic analysis between decrease of body weight or volume and inter- (≥3 mm) or intra-fractional (≥ 2 mm) variations.

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Fig 6.

(A) Box plot of intra-fractional variation of anterior-posterior direction per body weight variation group of 1 kg. (B) Box plot of intra-fractional variation of pitch per body weight variation group of 1 kg. (C) Box plot of intra-fractional variation of three-dimensional vector per body weight variation group of 1 kg.

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Table 8.

Optimal margins for PTV considering both inter- and intra-fractional variations.

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Fig 7.

(A) Intra-fractional error of patient number eight. Simulation had to be repeated in this patient after the 15th fraction. The average and standard deviation of three-dimensional intra-fractional variations before and after repeated simulation were 1.37±0.84 mm and 1.19±0.51 mm, respectively. (B) Intra-fractional error of patient number 11. Simulation had to be repeated in this patient after the 17th fraction. The average and standard deviation of three-dimensional intra-fractional variations before and after repeated simulation were 1.73 ± 1.02 mm and 1.46 ± 0.68 mm, respectively.

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Table 9.

Comparisons of calculated margins for planning target volumes with those of previous studies considering inter-fractional variations.

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Table 10.

Comparisons of calculated margins for planning target volumes with those of previous studies considering both inter- and intra-fractional variations.

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