2017_SBRT_Course Book

Risk adapted fractionation – Clinical Situation

Prospective Phase II trial Iyenger JCO 2014 • Maximum 5 Platin-resistant sites based on FDG-PET

• SBRT to all progressive sites, • Switch to concurrent Erlotinib

• 24 patients with 52 sites

1 Fx

3 Fx

5 Fx

In-field failure

3 / 21

Physical dose

19 – 24Gy 27 – 33Gy 35 – 40Gy

Out-field failure

10 / 21

Max BED 82Gy

70Gy

72Gy

No failure

10 / 21

Ø Excellent OS AND local tumor control lower SBRT doses

Matthias Guckenberger - ESTRO SBRT Course 2017

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Dose in SBRT – dose prescription

Conventional radiotherapy

Stereotactic radiotherapy

125%

100%

100%

95%

95%

Field size ↓ MUs ↑

Dose

Dose

Target

Target

Normal tissue

Normal tissue

Matthias Guckenberger - ESTRO SBRT Course 2017

07.09.17

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