How do you manage a stage I LLL medically inoperable lung cancer in close proximity to the stomach?
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.
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Mayo Clinic
Answered on
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). You could also look at...
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Mednet Member
Radiation Oncology · US Oncology
Answered on
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 of oral contr...
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