How do you approach treatment planning for lung SBRT in a patient with a lesion within 1 cm of a defibrillator?

V-fib requiring defibrillation poses an immediate life-threatening situation. Even if the patient doesn't regularly need their pacemaker, one would need to know that their defibrillator is functioning.

In this case, I don't think there's any choice except to move the pacemaker/defibrillator to the o...

I think the safest answer is, as others have mentioned, to consider moving the pacemaker.

However, to play a bit of devil's advocate-
Is the case definitive in nature? Are we talking 50-60 Gy in 3-5 Fx as Rx dose?
Or, if it's palliative, could you get away with lowering the dose at the edge closest to...

I agree with Dr. @Dr. First Last. Should be moved to the other side of the chest.

Based on the vignette that was posted, I'm not certain as to where the lesion is located. But if it's central and the ITV and PTV would be such that the dose might spill into the contralateral lung, I'd have the dosimet...

What can be said with the different types of technology. With what I am seeing in linac-based SBRT which is coplanar, I think this is a tough case as everyone points out. I used to have a cyberknife opening infinite beams in a sphere and the plans were much better and tighter. I am a retired basical...

Dosimetrically, at only 1 cm separation, there's no way you could complete SBRT without failing to meet the dose constraint for the defibrillator. It needs to be moved to the other side of the chest wall (or rarely the abdomen), as stated above. Don't approve a poorly conformal plan that would still...