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Topics:
Lung Cancer • Radiation Oncology • Thoracic Malignancies • Stereotactic Body Radiotherapy • Non-small cell lung cancer
Do you ever consider a dose constraint to the spleen when treating lung tumors with stereotactic radiotherapy?
I am treating a left lower lobe NSCLC and my PTV is so close to the spleen that a small portion of the spleen is getting significant dose. I cannot find mention of guidelines in the literature for evaluating the safety of this situation.
Answer from: Radiation Oncologist at Academic Institution
Spleen-schmeen. :) Which is a non-professional way so say I think it’s okay to treat it. If you consider we used to remove them for Hodgkin Lymphoma, they are important organs but not crucial. If you’re treating a corner of it (which I have done many times) you wi...
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Answer from: Radiation Oncologist at Academic Institution
I think the question sets up another question, namely under what circumstances (if any) might it be advisable to offer pneumococcal vaccination to someone treated for a splenic metastasis (admittedly quite uncommon, of course). Given how seldom we treat the spleen nowadays with conventional RT for l...
Answer from: Radiation Oncologist at Community Practice
I agree with @Brian D. Kavanagh re: considering vaccination.I routinely offer vaccination to patients with distal esophageal/GEJ tumors and for others with significant splenic RT dose. From Dr. Norm Coleman and Dr. Henry Kaplan in NEJM (1980) re: splenic atrophy https://www.ncbi.nlm.nih.gov/pub...
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Radiation Oncologist at Rutgers Cancer Institute of New Jersey
I have also immunized patients for pneumococcus, m...
I have also immunized patients for pneumococcus, m...
Radiation Oncologist at Radiation Oncology Associates PA
Here is an article on splenic radiation in pancrea...
Here is an article on splenic radiation in pancrea...