What is an acceptable SBRT dose for a central lung cancer encasing a coronary artery bypass graft?

As a Minnesotan, my immediate reply to your problem is "uff da, that's a tough one eh?". An image of the tumor location would really help here, but I'm going to presume it's maybe off the subclavian artery (longer course and may have more lung surrounding)? Either way, your patient is in a tough spot. I haven't faced this particular issue, so I have no experience to offer you. CABG has slowly gone the way of the do do bird as angioplasty with drug eluting stents have taken over so my first thought would be a cards consult to see if they could reopen the original vessel with angioplasty and stenting. If that's been ruled out my advice would be stent first, then SBRT and do 50/5 without constraining the dose. I wouldn't run it 20% hot like a ...