What are your dose constraints for SBRT pancreas (absolute and relative) when treating with 5 fractions?
What strategies do you use to meet those constraints?
Answer from: Radiation Oncologist at Academic Institution
We contour duodenum, other small bowel, and stomach separately and for each allow V33 < 1cc and max 0.035 cc < 36-38 Gy. We will sometimes also add a 3mm PRV for these organs (if close) and try to keep this v35 < 1-2 cc. Of note, some protocols allow for higher dose to these structures...bu...
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Radiation Oncologist at Lake Huron Medical Center Very helpful!
Answer from: Radiation Oncologist at Community Practice
I use a similar approach to Dr. @Nina Sanford. We deliver 40 Gy in 5 fractions to the GTV + TVI. The pancreas and an elective nodal volume get 33 Gy in 5 fractions. A PTV-eval is created cropped 2mm from all bowel structures for planning the 33 Gy volume. I deliver pancreatic SBRT with the...
Answer from: Radiation Oncologist at Community Practice
We have a Varian Truebeam with RPM so I've been treating and utilizing an exhale-breath hold technique with fluoroscopic visualization of fiducials during RT. As above, NPO 4 hours before tx. During simulation, I obtain multiple exhale breath hold scans to contour my GTV, TVIs, and OARs describ...
Very helpful!