How do you approach SBRT liver constraints when the total liver volume is <700 cc?
Liver SBRT maintaining 700 ccs of liver <15 Gy is a commonly used constrain; however, if the total liver volume is limited due to cirrhosis, prior resection or other causes, how do you approach liver constraints?
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Cleveland Clinic
Answered on
We consider 3 different methods of thinking about liver constraints when evaluating a plan:
1) Sparing 700 cc's to < 15 Gy (for 3 fractions), and <17 Gy (for 5 fractions).
2) Liver mean dose constraints (as in RTOG 1112 for CP A cirrhosis, <14 Gy), and <15-16 Gy for non-cirrhotic patients depending ...
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Mednet MemberInvited Expert
Radiation Oncology · Brigham and Women's Hospital
Answered on
I'm not aware of data that addresses this question. My understanding is that our constraint of sparing 700 cc of liver is extrapolated from surgical data, in which this is considered the minimal volume of residual liver required for adequate hepatic function following a partial hepatectomy. My pract...
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