What dose constraints do you use for 60 Gy in 15-20 fraction lung treatments that are adjacent to the hilum?
The LUSTRE trial, which is a Canadian RCT comparing SABR (60/8, 48/4) vs. 60/15 provides some max point constraints to address this for 15#.
Swaminath, Clin Lung Cancer. 2017 Mar;18(2):250-254.
Spinal Canal 36 Gy
Esophagus 48 Gy
Brachial Plexus 50 Gy
Heart 66 Gy
Great Vessels 66 Gy
Trachea/PBT 66 Gy
Skin ...
For tumors abutting the esophagus and PTV including a portion of the esophagus, what is your recommended dose fractionation? Esophageal Dmax is 50.5 Gy in SUNSET for 15 fraction regimen, which is difficult to achieve in this scenario without compromising PTV coverage. Thank you for your insight.
Could someone post the PTV planning objectives on the LUSTRE protocol? Specifically with regards to heterogeneity within the PTV. Unfortunately, the trial protocol is paywalled and my institution doesn't subscribe to that journal.