Course book Advanced Treatment Planning 2018

DOSE CONSTRAINTS: LARGE VESSLES

Great vessels (aorta, vena cava sup. and inf., brachiocephalic veins) (α/ß 3 Gy), potential side effects: hemoptysis and fatal bleeding Reference Number of

Number of centres

Pro (p)-/ retro(r)- spective

Results (max. point dose or dose/fractionation and EqD2 in Gy provided if possible)

reported patients (treated tumours)

Timmerman (50)

70

1

p Single cases of hemoptysis and fatal bleeding with varying SBRT regimens (s. bronchus)

20 °

Senthi (9)

(563)

r/p(4) Single cases of hemoptysis and fatal bleeding with varying SBRT regimens (s. bronchus: Song (51), Milano(62), Oshiro (63), Bral (36))

Canon et al. (65)

75*

1

p

(s. bronchus)

Recommendations/NT constraints Timmerman (66)

maximum point dose: 37 Gy (1 fraction regime – EqD2: 296 Gy ) 53 Gy (5 fraction regime – EqD2: 144.2Gy ) maximum point dose: 63 Gy (5 fraction regime - EqD2: 196,6Gy ) 75 Gy (10 fractions regime - EqD2: 157.5Gy )

RTOG 0813 (56)

EORTC 22113-08113

no restrictions, but recording of DVH data for toxicity

Adebahr et al , BJR 2015

German Cancer Consortium (DKTK)