When planning concurrent chemoradiation for locally advanced NSCLC, do you consider prescribing primary tumor disease to a lower isodose line, such as 75%, if OAR constraints for standard prescribing are met?

Topics: Radiation Oncology • Thoracic Malignancies • Non-small cell lung cancer

Answer from: Radiation Oncologist at Academic Institution

For stage III NSCLC, we routinely deliver 60 Gy to PTV with SIB 66 Gy to GTV in 30 fractions using IMRT with concurrent chemotherapy. Some clinical data indicated that primary tumors might need higher dose in order to achieve optimal local control. Therefore, it could be reasonable to consider an ev...

Comments

Radiation Oncologist at Mallory Radiotherapy, PLLC
Agree. I have been routinely prescribing with an S...

Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System
I remain yet to be convinced that 2.2 Gy/day makes...

Answer from: Radiation Oncologist at Academic Institution

For conventional fractionated radiotherapy, the usual normalizing isodose line is between 95% to 99% whereas for the SBRT technique, the normalizing isodose line could be between 80-90-92%. The goal of such planning is to create hot plans to deliver high dose to the target. However, for VMAT, becaus...

Answer from: Radiation Oncologist at Community Practice

NRG-LU008 will help answer the question of whether primary tumor RT intensification using modern techniques can improve outcomes. I encourage everyone who can participate to do so. NCT05624996

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