What RT dose/fractionation would you use to treat an unresectable grade 3 solitary fibrous tumor abutting the optic nerve and chiasm?  

Generally, I would consider treating an unresectable grade 3 solitary fibrous tumor to up to 59.4/60 Gy, or possibly higher. The location of this tumor makes it difficult to treat entirely using this dose while respecting the optic nerve/chiasm constraints. How is the patient's vision? If intact, op...

There isn't a perfect answer for this case, but we would consider 59.4 Gy-60 Gy in 1.8 Gy/2 Gy and maintain optic constraint of ~54 Gy abutting it and use ExacTrac/IGRT to be able to treat within 1 mm (i.e., let the constraint drive coverage). Interestingly, I also polled our sarcoma group, and a co...

From a non-CNS sarcoma standpoint, there is published European experience with definitive-intent RT for unresected SFT, and a clear dose-response relationship, with ~80% local control at 60+ Gy vs ~30% at lower palliative doses. Thus, trying to get as much of the tumor to a definitive dose, while re...

Before launching into XRT for this CNS patient, I would review with Sarcoma Med Onc regarding initial treatment with an antiangiogenic agent. SFTs have a relatively high rate of PR with those agents, which might provide some extra room for working around the visual apparatus. If embarking on that ap...