How would you treat a patient with oligometastatic disease to the lung for whom SBRT/SABR is not feasible?

Topics: Lung Cancer • Radiation Oncology • Palliation • Thoracic Malignancies • Stereotactic Body Radiotherapy

How would you approach treatment if SBRT was not technically possible?

How would you opt to treat if SBRT was instead not covered by insurance, and would this be different than your approach above?

Answer from: Radiation Oncologist at Community Practice

I am not sure what this means exactly, as far as not technically feasible. Very old machine? Lack of dosi/physics support? If you can do VMAT with image guidance at your machine, you can probably do SBRT/SRS. You just need to have physics do their thing. In America, we use a billing definitio...

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Radiation Oncologist at Stroger Hospital
70 Gy in 10 fractions.

Answer from: Radiation Oncologist at Academic Institution

If it is not technically possible because your machine does not have the feasibility to do SBRT (say, a machine that only does step and shoot with kVs, without VMAT or CBCT), then I would refer the patient out to a center/machine capable of doing SBRT. If insurance does not approve it, despite p2ps...

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