How do you define central lung cancers when considering SBRT?
While the RTOG protocol defines central in relation to the PBT, should distance to the trachea above the PBT, esophagus, heart, spinal cord, etc. be taken in consideration when determining fractionation?
Answer from: Radiation Oncologist at Academic Institution
Interestingly, I have never fully subscribed to the 2.0 cm "no-fly zone" concept and it was based on the need to ensure the safety of patients in our early experience. If one looks at the literature, the original All-Japan study did not differentiate between central and peripheral locations. The ori...
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Radiation Oncologist at Mon Health What are your thoughts about the Tekatli study, sh...
Radiation Oncologist at University Of Kentucky Hospital The issue of fatal hemoptysis is very complicated....
Answer from: Radiation Oncologist at Academic Institution
I follow IASLC ART committee recombination (Chang et al., PMID 25514807) and define "central lesion" as within 2 cm of critical structures including bronchial tree, esophagus, heart, major vessels, spinal cord, and brachial plexus. Severe toxicities have been reported with these critical structures ...
Answer from: Radiation Oncologist at Community Practice
Definitions are nice for studies and publications. However, for managing individual patients, I contour the PBT to the end of the lobar bronchi, stopping at the orifices to the segmental branches. I then expand the PBT + 10 mm with a dummy volume to see its proximity with the PTV. At this point, I d...
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Radiation Oncologist at Mon Health What about the CALGB fractionation scheme of 70 Gr...
Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System Unfortunately, we are in a data-free zone to know ...
What are your thoughts about the Tekatli study, sh...
The issue of fatal hemoptysis is very complicated....