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Radiation Oncology • Gastrointestinal Cancers
What dose fractionation would you utilize for a large solitary liver metastases about 7 cm, abutting colon?
The patient has a primary breast cancer with a single progressive metastasis in liver.
Answer from: Radiation Oncologist at Community Practice
Given that this is a solitary metastasis, I would favor surgery for this patient if adequate healthy liver volume can be spared and there are no other contraindications. This will offer the best outcome. If this patient is not resectable then the best regimen to treat this metastasis depends on...
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Answer from: Radiation Oncologist at Academic Institution
We prefer to use a 3-fraction regimen (eg: 45 Gy in 3 fractions) to treat such tumors. In this patient with metastasis, the liver is not likely to be cirrhotic (contrary to primary liver tumors) and the volume spared (liver volume minus GTV) is very likely to have normal metabolic function. Though t...
Answer from: Radiation Oncologist at Academic Institution
For those patients in whom surgical resection is not feasible, my prescription dose is 50 Gy in 5 and allowing the IGTV to have an average dose of 60 Gy. I will create a PTV 30 for the overlapping area of PTV and colon and a PTV 40 (about 5-7 mm region) for the area between PTV 30 and PTV 50, I will...