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What brachial plexus dose constraints do you apply when treating conventionally fractionated NSCLC?

Is it safe to keep median dose to the brachial plexus to ≤69 Gy per NCCN guidelines and maximum D2cc <75 Gy per Amini et al.?
3 Answers
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Radiation Oncology · Michigan Healthcare Professionals, PC
Answered on

Yes. I am presuming you are discussing treating definitively with CRT for locally advanced NSCLC.

Since RTOG 0617, most people that treat NSCLC prescribe to a dose of 60-66 Gy in 30-33 fx, as this is a feared toxicity that is very painful and decreases QOL. We try to keep the brachial plexus dose to ...

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Radiation Oncology
Answered on

Agreed with Dr. @Dr. First Last. Of note, if you are treating a superior sulcus tumor near the brachial plexus, you might consider the Intergroup 0160 regimen of pre-op chemoRT followed by surgery. In this trial, they used a dose of 45 Gy/25# with cisplatin/etoposide, but one could go higher to a de...

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Radiation Oncology · Kona Community Hospital
Answered on

NCCN lists median brachial plexus dose constraint as < 69Gy for conventionally fractionated 30-35Fx regimen. (When I inquired a while back, they confirmed this wasn't a typo).

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