What dose constraints do you use when treating ultra-central lung tumors with a hypofractionated/ultra-hypofractionated approach using 8-10 fractions?

Topics: Radiation Oncology • Thoracic Malignancies

Answer from: Radiation Oncologist at Academic Institution

Typically, ultra-central lung tumors mean that they abut/invade critical central structures such as the bronchial tree, tracheal, esophagus, major vessels, etc. For these critical structures, particularly for the esophagus, bronchial tree and tracheal, ablative dose could cause severe chronic toxici...

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Radiation Oncologist at Mon Health
What are your thoughts about the CALG regiment of ...

Radiation Oncologist at University of Texas MD Anderson Cancer Center
Occasionally, we use 70 Gy in 20 fractions as long...

Radiation Oncologist at Mon Health
Thank you.

Answer from: Radiation Oncologist at Community Practice

This is what we use when we treat central lesions - 70 Gy in 10 fractions.Total Lung Mean dose ≤ 9 , V40 ≤ 7%Trachea V40 ≤ 1cc, Dmax ≤ 60GyBronchial Tree V50 ≤ 1cc, Dmax ≤ 60GyHilar Major Vessels V50 ≤ 1cc, Dmax ≤ 75GyOther Chest Great Vessels V50 ≤ 1cc, Dmax ≤ 75GyEsop...

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Radiation Oncologist at West Virginia University Medicine
Nice! I'd also like to point out the SUNSET constr...

Radiation Oncologist at McMaster University School of Medicine
Also, be wary of V20 of both and ipsilateral lung ...

Answer from: Radiation Oncologist at Community Practice

In Canada, we have had a lot of experience with 60 Gy in 15 fractions for early lung cancer, and with ultra central tumors, this is our centre's usual go-to fractionation, unless patients are enrolled on the currently ongoing SUNSET trial. The constraints for 60/15 are largely based on the completed...

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