Do you contour and constrain cardiac substructures when treating locally advanced NSCLC with chemoradiation?
If so, which substructures (LAD, left ventricle, etc.)?
2 Answers
Mednet Member
Radiation Oncology · University of Cincinnati
Answered on · Updated on
In my practice, I have typically contoured the heart and left ventricle. As long as the heart contour is adequately high (I typically stop after the left atrial appendage), the left coronary system is included in the overall heart contour. (See figures 1-3B in Feng et al., PMID 20421148).
As far as c...
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Mednet MemberInvited Expert
Radiation Oncology · Cedars-Sinai Medical Center
Answered on
In my practice, in addition to the heart, I typically contour the LV, LAD, +/- L circumflex (depending on proximity to target). The Feng et al., PMID 20421148 atlas is a great reference.
For constraints, the first principle is obviously ALARA, and I typically tier whole heart to goal <10 Gy if feasib...
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