2017_SBRT_Course Book

Risk adapted fractionation

• Operable patient stage I NSCLC • Peripheral location

with

Total Dose

3 x 18Gy

• Oligoprogressive stage IV NSCLC • Central location

Relevance of long-term LC

5 x 7Gy

# of fractions

Dose to critical serial OARs

Matthias Guckenberger - ESTRO SBRT Course 2017

07.09.17

25

/

Risk adapted fractionation – tumor location Central location

3 x 20 – 22Gy ~ 50% severe toxicity @ 2 years

Timmerman JCO 2006

5 x 10 – 12Gy 5 x 10-11Gy: 2 in 34 G3-5 Tox 5 x 11.5-12Gy: 13 in 86 G3-5 Tox

Chang JTO 2015 • SBRT for central location - standard practice • Optimal dose and definition of “too” central lacking Bezjak IJROBP Supp 2015

Matthias Guckenberger - ESTRO SBRT Course 2017

07.09.17

26

/