What is an acceptable maximum "bridging" dose between SRS/SRT targeted brain metastases in close proximity to one another?

What maximum dose do you allow to “connect” adjacent metastatic lesions receiving SRS/SRT? What is this value for one-, three-, and five-fraction plans?

2 Answers

Mednet Member

Radiation Oncology · Karmanos Cancer Institute - McLaren Proton Therapy Center

Answered on

Hi @Dr. First Last, hello from your neighbor in Flint, I hope this helps:

I use "Brain Minus GTV" as my normal brain OAR, and to reduce the risk of radiation necrosis/edema, I try to keep it under:

V12 at 5 cc or less for single fraction SRS; above that I will fractionate
V28.8 at 7 cc or less when ...

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Mednet Member

Radiation Oncology · Physician Health Partners

Answered on

Until we have data, I think 300x10 is adequate.

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