How does the recent publication of RTOG 0813 affect your management of centrally located lung tumors?

RTOG 0813 s a very valuable data set. This was the first trial using the TITER method performed within NRG Oncology (formerly RTOG). When 0813 was written, we fully expected there to be more toxicity events than were actually experienced. Please remember that we did not limit dose to central structu...

The publication of RTOG 0813 in which the toxicity was acceptable (less than 10% >Grade 3) makes me more comfortable with a 5 fraction regimen for centrally located tumors. But, as stated by @Dr. First Last, the study was not designed to allow us to make a final "recommended dose". The toxicity was ...

I have treated central lung tumors <4cm with 50Gy in 5 fractions for many years and rarely had any issues, and with excellent local control. There is also substantial data from Japanese investigators that dose-fractionation schemes of 50Gy in 5 or 48Gy in 4 were well tolerated when treating central ...

Referring to the table below:

• 54 Gy 3 fx BED10 = 151 Gy BED3 = 378 Gy
• 60 Gy 5 fx BED10 = 132 Gy BED3 = 300 Gy
• 55 Gy 5 fx BED10 = 115 Gy BED3 = 256 Gy
• 48 Gy 4 fx BED10 = 105 Gy BED3 = 240 Gy
• 50 Gy 5 fx BED10 = 100 Gy BED3 = 216 Gy

Given the theoretical limitations of BED for large fractions, it...