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The balloon is going to be a random error decreaser (which, in theory, for every 1mm decrease in random error is a 0.7mm decrease in PTV)i always liked the balloon, but staff not so much. Patients didn’t complain (I would ask - there were jokes, but no one said painful).
But why both spacer and balloon??
The spacer is going to be a rectal sparer/use your larger margins at same time/have larger margin cake/conformal cake and eat it too
In a way it’s like lobbing a MOAB *and* tactical nuke at a city block… should definitely work!