How do you manage a stage I LLL medically inoperable lung cancer in close proximity to the stomach?
In patients with aberrant anatomy due to previous surgery with lung PTV overlapping the stomach, how much would you dose de-escalate? Even conventional doses would exceed stomach tolerance.
Answer from: Radiation Oncologist at Academic Institution
This is a rare but not uncommon problem (or maybe unusual but not infrequent...). There’s a couple ways to approach this, depending on the tools in your department‘s toolkit. These low lying LLL lesions are ones that I always treat with breath hold (or gated if you have that)...
Comments
Radiation Oncologist at Cleveland Clinic Absolutely agree with Ken. In addition to what he...
Radiation Oncologist at Penn State Milton S Hershey Medical Center Agree. I also noticed the same challenge for patie...
Answer from: Radiation Oncologist at Community Practice
Agree with the prior recommendations of Drs. Olivier and Stephans. Two other potential tips:
1) Oral simethicone to break up gas bubbles 4-6 hrs prior to the sim and each daily treatment, and then NPO
2) Gravity may be your friend with the mobile stomach. NPO for 4-6 hrs and then a sip o...
Absolutely agree with Ken. In addition to what he...
Agree. I also noticed the same challenge for patie...