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Topics:
Radiation Oncology • Gastrointestinal Cancers
Do you base liver SBRT dose fractionation on size, volume, or proximity of normal tissue?
For example, would you use a cutoff such as PTV of 25 cc, or 4 cm diameter, or simply use nearby normal tissue constraints to alter your fractionation from 20 Gy x 3 fractions to a more fractionated course?
Answer from: Radiation Oncologist at Academic Institution
@Christopher H. Crane's paper (Tao et al., PMID 26503201) is a very good report on IHC, and given the fact that few other institutions can accumulate such a sizeable experience, I think it is hard to argue with their nuanced approach in that setting. Their discussion acknowledges all of the caveats ...
Answer from: Radiation Oncologist at Academic Institution
The stricture risk with 3-5 fraction SBRT is still probably an open question for small non-biliary tract cancers. It is a resistant structure, but the consequences can be high, anywhere from lifelong dependence on stent exchanges to cholangitis or even death if a stricture develops. I have seen anec...
Comments
Radiation Oncologist at Mallory Radiotherapy, PLLC
Do you have any concerns about using the 75/25 fra...
Do you have any concerns about using the 75/25 fra...
Radiation Oncologist at Memorial Sloan-Kettering Cancer Center
The number of fractions helps to manage interfract...
The number of fractions helps to manage interfract...
I have a patient with a 22 cm HCC involving almost...
Most of the HCC patients I see have very large tum...