Palliative care 2016

SBRT- proper patient selection

Inclusion • Able to lie flat for extended period of time 40-50 minutes • Reasonable performance status • Lesion clearly identified on CT or MRI • Limited number of lesions ≤ 2-3 spinal levels • Gross tumor ≥ 3-5 mm from spinal cord

Patient A

Patient B

Patient C

Exclusion • MSCC • no MRI possible • recent 89 S • prior RT to 45 Gy2 • spinal instability

distress

relaxed

nervous

nervous

performance

good

good

poor

physical complaints

no pain

no pain

highly symptomatic

set up error

1 mm

3 mm

5mm