Should lung SBRT fractions be delivered on consecutive days, every other day, or perhaps an even more prolonged schedule?
For North Ameridcan Radiaton Oncologists whose experience with lung SBRT began when they participated in one or both of the RTOG lung SBRT protocols (0236, 0813), they would have quickly learned that their patients would be classified as having either "peripheral" or "central" tumors based on the de...
I think the polling results should be taken with a grain of salt. While most of us continue to give 54/3 for peripheral lesions based on our comfort level enrolling on RTOG 0236 and the significantly larger doses being given, at least for 5 fx regimens the data suggest no difference in toxicity or c...
This is a great question. Which is really just another way of saying "I don't know the answer." The reference that the questioner cites is a patient that we treated on a prospective study of tumor hypoxia using FMISO PET/CT scans - we've now observed a significant increase in tumor hypoxia after the...
There was also a multi-institutional retrospective study that looked at this question for patients with ≥5-cm NSLC treated with SBRT of 5 fractions or less. They found fewer overall and pulmonary grade ≥2 toxicities for patients treated every with non-daily regimens when compared to daily regime...
Nobody knows the correct answer.... but having treated well over 1000 lung sbrt patients I look at it a bit pragmatically. The results, particularly when it comes to things like colorectal mets, look a tad better with every other day. I would also do every couple of days for 54/3. So overall, I have...
This more recent article from Sampson in PRO may help shed more light on this question in favor of QD treatment (https://www.ncbi.nlm.nih.gov/pubmed/29907514): modern technique SBRT treated within past 3 years (analysis limited to 2015-2016) instead of 2003-2014 in the Alite, et al paper referenced ...
Someone looked at this. Check it out. https://www.ncbi.nlm.nih.gov/pubmed/27543255
There's another paper from one of the Toronto programs that looked at this question prospectively for pneumonitis rates. I'll post it when I can find it again.
EDIT:
My bad, it was from the UK.