1498 / 1835
ConsolidationVolume Radiotherapy / Residual
Site Radiotherapy
•
Deliver the radiation
only to the remaining CT abnormality
of a previously
involved lymph nodes or organs that remain 1.5 cm or larger after BV-AVD
•
Use high-quality CT scan with IV contrast
•
Field is independent of the original size of the disease
•
Lymph nodes that have resolved or are smaller than 1.5 cm will not be irradiated
•
Volume definition-
–
GTV (gross tumor volume) is the post chemotherapy residual CT
abnormality.
–
CTV (clinical target volume) is the GTV with minimal additional margins
influenced by imaging uncertainty and motion.
–
PTV (planning target volume) is added if necessary for beam or plan qualities
and influenced by patient immobilization.
•
Dose prescribed to the to the PTV is 30.6 Gy (1.8 Gy daily X 17 fractions in 3.5
weeks).
•
Either IMRT or 3-D conformal planning is allowed
•
Deep Inspiration Breath Hold (DIBH) for mediastinal sites is encouraged