PMC9983128_01
Contrast-enhanced CT at the first medical examination. The red arrow indicates dilatation and thickening of the wall of the intestine. The blue arrow indicates free air and mesenteric fat stranding in the abdomen. CT, computed tomography.
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Computed tomography (CT) revealed intestinal dilatation, intestinal wall thickening, free air, and mesenteric fat stranding in the abdomen (Fig. 1).
Dose distribution for RT. (A-C) Axial image at small bowel, sigmoid, and lower lobe of the right lung lesions, (D) coronal image, and (E) sagittal image. Color areas denote distribution over 10 Gy. RT, radiation therapy.
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Furthermore, overlap between the areas was avoided, and the areas were irradiated by two non-opposite fields with wedges (Fig. 2).
CT before RT (A-C) and contrast-enhanced CT just after RT (a-c). The red arrows indicate each individual lesion. A/a, small bowel; B/b, sigmoid; C/c, lower lobe of the right lung.
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On the final radiation day, immediately after the radiation, CT showed shrinkage of all tumors (tumor size before and after RT were as follows: around the small bowel, 10.8 x 6.1 x 13.1 cm and 6.8 x 4.2 x 2.8 cm; sigmoid, 2.7 x 2.7 x 10.5 cm and 1.7 x 2.0 x 4.9 cm; and right lung, 3.0 x 3.1 x 2.0 cm and 3.0 x 1.5 x 1.3 cm, respectively) (Fig. 3).