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PURPOSE To investigate the impact of interfractional anatomical changes and setup correction methods on dose distributions in pancreatic cancer patients under breath-hold conditions. METHODS Three intensity-modulated proton therapy (IMPT) plans with different beam arrangements and one volumetric-modulated arc therapy (VMAT) plan prescribing 54 Gy in 30 fractions were created for 10 patients who underwent three additional CT scans performed at an interval of 1-2 weeks. The additional CT sets were rigidly registered to the simulation CT se