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Practical considerations for lung planning…
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4D simulation with PET/CT fusion:
Limit patient
acceptance to < 1 cm respiratory tumor excursion
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ITV
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Expand ITV + 7mm= CTV
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CTV + 5mm= PTV
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Typically use 3 beams (can treat 2 fields/day)
•
Limit 1/3 of the beams to range into critical structure
(cord/esophagus/ heart etc)