I think about this differently than most people do. My goal is to deliver an ablative dose (100Gy BED) regardless of the proximity of organs at risk or the size of the tumor. The more common thing to do is to reduce the dose of radiation below an ablative dose to 40 or 30Gy in 5 fractions. I'm not s...

@Christopher H. Crane's paper (JCO 2016 34:3, 219-226) 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 inh...

The stricture risk with 3-5 fraction SBRT is still probably an open question for small nonbiliary 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...