What target volumes do you use for cavity SRS following surgical resection of brain metastases?

Update: Essentially, my answer is the same. I'd add that often the sx tract is covered with PTV and I might extend that if its close. But surgical tracts can be extensive. There's a nice paper by Byrne et al. out of MGH from the excellent Helen Shih's group. This is a good option to consider if you ...

This is a great question. When tumor touches the dura, I have usually covered the dura with more than 3 mm (the margin I use around the cavity otherwise), probably 5 mm. As to whether the surgical tract gets covered, I think it gets covered quite routinely because it isn't so much of a "tract", i.e....

1. Based on reports of pre-op, that would be the preferred approach unless symptoms/pathologic diagnosis preclude pre-op SRS.
   
   
2. Post op, I would add a 2 mm margin around the resection cavity (literally place a 4 mm cursor and center at the rim and contour each slice, and then add a cap on both ends to c...