How do you manage a stage I LLL medically inoperable lung cancer in close proximity to the stomach?

Topics: Lung Cancer • Radiation Oncology • Thoracic Malignancies • Stereotactic Body Radiotherapy • Non-small cell lung cancer

In patients with aberrant anatomy due to previous surgery with lung PTV overlapping the stomach, how much would you dose de-escalate? Even conventional doses would exceed stomach tolerance.

Answer from: Radiation Oncologist at Academic Institution

This is a rare but not uncommon problem (or maybe unusual but not infrequent...). There’s a couple ways to approach this, depending on the tools in your department‘s toolkit. These low lying LLL lesions are ones that I always treat with breath hold (or gated if you have that)...

Comments

Radiation Oncologist at Cleveland Clinic
Absolutely agree with Ken. In addition to what he...

Radiation Oncologist at Nazareth Hospital
Agree. I also noticed the same challenge for patie...

Answer from: Radiation Oncologist at Community Practice

Agree with the prior recommendations of Drs. Olivier and Stephans. Two other potential tips: 1) Oral simethicone to break up gas bubbles 4-6 hrs prior to the sim and each daily treatment, and then NPO 2) Gravity may be your friend with the mobile stomach. NPO for 4-6 hrs and then a sip o...

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