How do you control for organ motion when treating pancreatic cancer?

Typically I use a forced breath hold to essentially eliminate motion so that setup variation is all that we have to deal with after delineating a tumor on CT.

Options for managing respiratory motion include gating, abdominal compression, “ABC” (active breathing control), “DIBH” (deep inspiration breath hold) and others. I’m not aware of literature comparing the relative strengths and weaknesses of these approaches, particularly in pancreatic cancer.

My pr...