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When treating bladder cancer with 55 Gy in 20 fractions, what small bowel dose constraints do people use?   

The protocol for the James trial (NEJM 2012) states: "non-target tissue may be excluded at the discretion of treating physician." For gyn applications, rad oncs are using D2cc bowel to 60 Gy (and possibly 65 Gy) and D5cc of 55 Gy. As one approach, these could be converted to 20-fx limits. Another approach is to use a D0.035cc of 53.5 Gy. Is there experience in treating to 55 Gy in 20 fx to a PTV that includes small bowel (without underdosing the overlap with the bowel)?



Answer from: Radiation Oncologist at Academic Institution
Comments
Radiation Oncologist at Mayo Clinic
Great question and one that doesn’t have any...
Radiation Oncologist
Dr. @Bradley J. Stish, what dose to regional nodes...
Radiation Oncologist at Mayo Clinic
Dr. @Lara P. Millar, I don't often treat elective...
Radiation Oncologist at Lake Huron Medical Center
Do people routinely include prostate/prostatic ure...
Radiation Oncologist
I don't include prostate in the CTV unless T4 BUT ...
Radiation Oncologist at Radiant Oncology
@Bradley J. Stish- There is no cone-down on the 55...
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