Is there a current 'standard of care' dose and fractionation in treating lung cancer with SBRT?
There seem to be a lot of different fractionation schemes in the literature. Is there one that is most standard?
Answer from: Radiation Oncologist at Academic Institution
We have previously discussed the right BED dose equivalence for SBRT; one of the questions that is posed is which schema is "standard"? There is no one single standard scheme. We recommend that as an institution, you develop a process and scheme that works within your structure and workflow; we te...
Answer from: Radiation Oncologist at Academic Institution
I agree with @Minesh P. Mehta that the most compelling clinical evidence we have for radiation dose for lung SBRT is based on datasets reporting BED for various regimens. 2 datasets, published by Onishi et al. and Grills et al., respectively, show that local control is optimized if the BED is g...
Answer from: Radiation Oncologist at Academic Institution
An interesting caveat to keep in mind is that not every group defines the prescription the same way. For example, the Japanese early experience as described in Onishi often prescribed the dose to the isocenter. The dose given to the edge of a PTV is, then, on the order of 90% of that depending on ...
Answer from: Radiation Oncologist at Community Practice
Currently, there are a number of different fractionation regimens that are "standard". I think tumor size and location may play into potential variations of dose fractionation schemes. I have successfully used 60 Gy in 3 fractions, 48 Gy in 4 fractions, and 50 Gy in 5 fractions.&nb...