If you missed the #CTOS2019 talk by @Notorious_RBE, this one is for you!
Thats right: you want 30% cold spots in tumor. (👇 #MedPhys reaction).
Dramatic response in rads refractory sarcoma: link.springer.com/article/10.100…
Case series of 71 palliative patients: ncbi.nlm.nih.gov/pubmed/1052442…
Peep this excellent review by Billena and Khan: ncbi.nlm.nih.gov/pubmed/30684666
GRID = 2D planned (dose “spears”)
LATTICE = 3D planned, including IMRT or VMAT (dose “spheres”)
SBRT is not safe for big tumors.
Ugh.
So I gathered a team #MedPhys and #Dosimetrist and we got to work. I declared a standard 20 Gy/5 Fx to be the “cold” whole tumor dose (30%), which made the hot spots 66.7 Gy (100%). We had our Rx, so got to planning. Dose constraints per AAPM 5 fx SBRT.
Close to other pub’d techniques: bit.ly/33ZsOi9
Here is what’s coming:
Hope to see you all in April! therss.org/UploadedDocs/2…