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What dose-fractionation scheme and esophageal constraints should be used to treat an ultra-central, medically inoperable, stage I NSCLC abutting the esophagus?

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Mednet Member
Mednet Member
Radiation Oncology · University of Texas MD Anderson Cancer Center

For lesions abutting the esophagus, SBRT with BED >100 Gy should NOT be used due to high risk for ulceration and even fistula. Instead of SBRT, more fractionated radiotherapy with BED <84 Gy should be considered (60 Gy in 15 FX is still too high for the esophagus). In addition to maximal point dose,...

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Mednet Member
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Radiation Oncology · UCLA | VA Greater Los Angeles Healthcare System

I prefer to prescribe 60/15 to the PTV with no more than 45/15 to the esophagus. Gated treatment targeting the GTV (instead of free-breathing targeting the iGTV) is strongly preferred for cases like this.

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