235 / 1578
/
Risk adapted fractionation – Clinical Situation
Ø
Excellent OS AND local tumor control lower SBRT
doses
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
Physical
dose
19 – 24Gy 27 – 33Gy 35 – 40Gy
Max BED 82Gy
70Gy
72Gy
In-field failure
3 / 21
Out-field failure
10 / 21
No failure
10 / 21
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Matthias Guckenberger - ESTRO SBRT Course 2017
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/
Dose in SBRT – dose prescription
Dose
Conventional radiotherapy
Dose
Stereotactic radiotherapy
95%
95%
125%
100%
100%
Target
Target
Normal tissue
Normal tissue
Field size ↓
MUs ↑
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