Modified simultaneous integrated boost radiotherapy for an unresectable huge refractory pelvic tumor diagnosed as a rectal adenocarcinoma

Figure 3 Macroscopic findings before radiotherapy. A: Day 0. The tumor is exposed from the perineum with oozing of blood, offensive odor and sever pain; B: Day 28 from the start of radiotherapy. The tumor was shrinking due to the modified SIB technique. Leakage of urine from a bladder fistula was observed; C: Day 56. Further tumor shrinkage is observed, but a slight residual tumor is present. The defect in the healthy tissue was shrinking; D: Day 180. The macroscopic tumor as well as exposure of the mucosa also disappeared. The patient could walk normally.