Please select the option that best describes you:
How do you approach adaptive planning in lung cancer?
Are there any rules you follow? Do you shrink target volumes if you notice a significant response (via CBCT) in a bulky lung tumor with fractionated radiation? Does NSCLC vs. SCLC make a difference in your decision making? There are some tumors that seem to regress with pushing borders in the lung, but there is concern that tumors don't just "pull away" as they're responding in real time, but rather "disintegrate". What are your criteria for rescanning?
Answer from: Radiation Oncologist at Academic Institution
The role of adaptive radiotherapy in lung cancer is still under investigation.
I do daily CBCTs on my definitive NSCLC and small cell lung cancer patients. I only adapt plans if there is a change in anatomy such as opening of a collapsed lung or tumor growth outside of the PTV.
I do not shrink vol...
Sign in or Register to read more
Answer from: Radiation Oncologist at Academic Institution
I only use adaptive thoracic RT for non-small cell lung cancer when faced with a large tumor associated with a (subjectively judged) high lung V20 (for example, >30-35%). Tumors treated with concurrent chemo-radiotherapy have a reasonable chance of shrinking (15-20%), so I replan around 36-40 Gy....