How do you approach volumes and dosing when using SBRT for a biopsy-proven NSCLC lung nodule with a central solid component and surrounding ground glass opacity (GGO) appearance?
@Dr. First Last, first of all, congratulations on finding our rather obscure article. It's heartening to know that it's impact has reached such high levels that a specific literature search on the topic by my esteemed colleague @Dr. First Last fails to find the article. I shall have to resort to soc...
Join for free or sign in to see the full answer
I would agree. There's no data not to treat the ground glass component. When reasonable, I include all that in the ITV volume. I suppose if the GGO component is > 4 cm, and one run into an issue with normal tissue, I would try to reduce the PTV margin first before lowering the dose to the GGO compon...
Join for free or sign in to see the full answer
The only series that I have run across addressing SBRT in adenocarcinoma in situ/minimally invasive adenocarcinoma is one reported by the Washington University group (http://www.ncbi.nlm.nih.gov/pubmed/23286648). From my interpretation of the article, it looks like they included the GGO component in...
Join for free or sign in to see the full answer
I had a similar situation this week. Patient had a prior Stage 1 (1997) tx with surgery and a GGO that has progressed, now with several small nodules, minimal PET activity, and a biospy showing low grade invasive ACA. The GGO component, however, measures 10 cm and has a very complex shape. Nuke the ...
Join for free or sign in to see the full answer