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DOSE CONSTRAINTS
THORAX
- Chronic lung disease: 70% of the lung <17 Gy.
- Healthy lungs: 60 % of the <20 Gy.
- Esophagus: Dmax < was 4.0 Gy per fraction.
- Chest wall: <30 Gy to 30 cc and <60 Gy to 3 cc.
- Spinal cord: <2 Gy per fraction and <45 Gy total.
CONTOURS
- GTV: defined only as the solid abnormality on CT + PET
- ITV: using a multiple CT scan (free breathing, maximal inspiration, and maximal
expiration)
- PTV: 0.5 cm in the axial plane and 1.0 cm in the craneocaudal plane
DOSE PRESCRIPTION
- Lung (not chest wall): 3 fractions of 20 Gy
- Lung (chest wall): 3-5 fractions of 12 Gy for lesions
- Lung (central): 8 fractions of 7.5 Gy
CHEMOTHERAPY (90%)
- FOLFOX/FOLFIRI
Sole CV, Lopez Guerra JL, et al. Clin Transl Oncol. 2013