Topics:
Radiation Oncology • Thoracic Malignancies
What dose do you use for single fraction SBRT when treating a small, peripheral early stage NSCLC?
Assume that the volume of the tumor is <10 cc (equivalent diameter of 2.7 cm). Assume there is not a significant amount of overlap of the PTV with chest wall or any other OAR aside from parenchyma.
Answer from: Radiation Oncologist at Academic Institution
Will echo Dr. @Gregory M. Videtic's comments.We treat exclusively with 34 Gy in 1 fx to all non-central lung tumors. Previously treated 27 Gy in 1 fx. While the initial trial was with 30 Gy, that was without heterogeneity correction so the delivered dose was likely 27 Gy to the periphery with het co...
Comments
Radiation Oncologist at Southeast Radiation Oncology (SERO)
Always good to look at one's own outcomes and adju...
Always good to look at one's own outcomes and adju...
Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System
I've treated half a dozen PTVs overlapping the che...
I've treated half a dozen PTVs overlapping the che...
Answer from: Radiation Oncologist at Academic Institution
The Stanford iSABR international phase II trial used an individualized volume, location, and histology adapted SABR dosing regimen.Out of 285 treated tumors, 159 were small (GTV<10cc), peripheral tumors that were prescribed 25 Gy single fraction per protocol. 5-year treated tumor recurrence rate ...
Comments
Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System
The Gensheimer et al., PMID 37707820 study defined...
The Gensheimer et al., PMID 37707820 study defined...
Radiation Oncologist at Stanford University School of Medicine
Per the protocol, included as supplementary materi...
Per the protocol, included as supplementary materi...
Answer from: Radiation Oncologist at Academic Institution
Interesting question and to be honest, I have only done a few cases of single fraction SBRT and tend to favor the 3-5 fraction approach but in the cases I have done it, I go to 34 Gy based on RTOG 0915. If I am not able to meet an OAR, then I would consider fractionating to 3-5 and not underdosing m...
That's interesting! Based on your paper showing no...
Yes, we do since that is in keeping with the 0915 ...
Makes sense!