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Radiation Oncology • Thoracic Malignancies
How do you contour and dose definitive CRT target volumes for an unresectable NSCLC invading vertebral bodies?
Do you cover the entire involved vertebral body with an elective dose volume (similar to spine mets)? How do you balance cord tolerances with coverage?
Answer from: Radiation Oncologist at Academic Institution
This is both an excellent and a complicated question.
While I do not typically favor elective nodal radiation in NSCLC, I do think this is a case where some degree of elective coverage is warranted.Different imaging modalities yield very different contours when it comes to bone invasion in NS...
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Answer from: Radiation Oncologist at Academic Institution
While I agree with @Kevin Stephans' thoughtful approach (in particular, always using spinal MRI to define the degree of invasion), I would allow a maximum spinal cord dose to reach 54 Gy in view of the potential devastating impact of any local failure, such as cord compression. In my mind, this is a...