What dose/fractionation would you choose for resected tail of pancreas adeno with positive margin, node negative?
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2 AnswersMednet Member
Radiation Oncology · Memorial Sloan-Kettering Cancer Center
62.5 Gy in 25 fx to the margin if R1. If R2, 75 Gy in 25 fx with motion management. Regional nodes get 45 Gy in 25 fx. Max point dose to the stomach and jejunum 60 Gy.
Mednet Member
Radiation Oncology · University of Alabama at Birmingham
If bowel is favorable to achieving typical constraints, 5 fraction SBRT is an option (since there are no anastomoses with a typical distal pancreatectomy). Can treat 40-50 Gy/5 fraction to +margin (pancreatic resection margin + at least 1cm for CTV high) with ENI 25/5. Breath hold; triggered imaging...