Topics:
Radiation Oncology • Thoracic Malignancies
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.?
Answer from: Radiation Oncologist at Community Practice
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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Answer from: Radiation Oncologist at Academic Institution
Agreed with Dr. @Simul Parikh. 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 defi...
Answer from: Radiation Oncologist at Community Practice
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).
Comments
Radiation Oncologist at UTHSCSA
I am not sure why NCCN has not corrected this. The...
I am not sure why NCCN has not corrected this. The...