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What is your preferred fractionation scheme for spine SBRT for radioresistant histologies?
Any best evidence for a given schema?
Answer from: Radiation Oncologist at Community Practice
I have not changed my doses based on "radioresistance" as this is a bit of a nebulous concept with heterogeneity intra/inter-patient.
I have typically done 27 Gy in 3 fractions or 24 Gy in 2 fractions.
I am not aware of any evidence showing different outcomes based on the scheme. I typ...
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Answer from: Radiation Oncologist at Academic Institution
As long as it's safe, and I can meet the OAR constraints, I escalate the GTV (but not the entire VB) to 20-24 Gy in 1 fx, 28 Gy in 2 fxs, 30-33 Gy in 3 fxs, 35-40 Gy in 5 fxs. While more work has been published in escalation with single fraction, I find that it's easier to safely escalate those to 4...
Answer from: Radiation Oncologist at Academic Institution
Agree with prior comments that higher-level evidence is needed.Based on data suggesting worse tumor control as well as higher rates of re-irradiation with radioresistant histologies, we tend to escalate to 28 Gy/2, 30-33 Gy/3, or 40 Gy/5, in line with HyTEC data, to achieve 85-90% probability of dis...