Current Gold Standard • Surgery remains gold standard for early stage lung cancer • Many patients cannot or prefer to not undergo surgery • SBRT/ SABR is emerging, improving • Radiosurgery targets only primary tumor • Control at 1 O site excellent • But +/- 15% recur regionally (with T1& T2 patients, adequate follow • Identify regions at highest risk of micro-metastatic disease • Deliver ablative radiation to primary nodal drainage Problem Concept Under Investigati on
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
CurrentGoldStandard
•Surgery remains gold standard for early stage lung cancer•Many patients cannot or prefer to not undergo surgery•SBRT/ SABR is emerging, improving alternative
•Radiosurgery targets only primary tumor•Control at 1O site excellent•But +/- 15% recur regionally (with T1& T2 patients, adequate follow up, imaging at follow-up & actuarial method)
•Identify regions at highest risk of micro-metastatic disease•Deliver ablative radiation to primary nodal drainage
Problem
Concept Under Investigation
Pulmonary Interstitial Lymphography
Pulmonary Interstitial Lymphography
Primary Nodal DrainageSquare = primary tumor
Circle = primary drainage
5 fractions, simultaneous integrated boost RapidArc, >340 d
PTV 50 Gy (primary tumor) coverage Normalized to 95%
PTV 35 Gy (nodal drainage) coverage (all >, med) 95%, 99.6%
Modulation: MU/cGy ratio (med, max) 2.8, 3.3
Conformality: V50/ PTV volume (med, max) 1.07, 1.10
NTC: Spinal cord V13.5 (med, max) 0.00, 0.20 cc
NTC: Cent airway V18 (med, max) 8.5, 17.2 cc
NTC: Total lung V20 (med, max) 5.5, 7.6%
NTC: Esophagus V27.5 (med, max) 0.0, 9.7 cc
NTC: Heart V32, Gr Vessells V47 (med) 0.10, 0.00
Treatment Planning per 0813
Related Documents
