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What dose-fractionation would you use to treat a single large melanoma lung metastasis?

How does your fractionation choice change if the lesion is abutting the pleura?
1 Answer
Mednet MemberInvited Expert
Radiation Oncology · University of Washington School of Medicine
Answered on · Updated on

Given the radioresistant nature of melanoma, for a 4 cm lung oligometastasis, I would carry the dose to 50 Gy in 5 fractions. Even if the tumor is abutting the lateral parietal pleura, I do not reduce the prescribed dose. I understand that one may be concerned about rib fractures. However, in my experience, the fracture will heal with time. An attempt to spare the chest wall will result in undercoverage of the PTV. If the tumor is located centrally and abutting OARs, I would use the technique de...

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