How do you approach adaptive planning in lung cancer?  

Are there any rules you follow? Do you shrink target volumes if you notice a significant response (via CBCT) in a bulky lung tumor with fractionated radiation?  Does NSCLC vs. SCLC make a difference in your decision making? There are some tumors that seem to regress with pushing borders in the lung, but there is concern that tumors don't just "pull away" as they're responding in real time, but rather "disintegrate".  What are your criteria for rescanning? 



Answer from: Radiation Oncologist at Academic Institution

Answer from: Radiation Oncologist at Academic Institution