Palliative care 2017

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

Exclusion

• MSCC

• no MRI possible

• recent

• prior RT to 45 Gy2

• spinal instability

Patient A

Patient B

Patient C

distress

relaxed

nervous

performance

good

poor

physical

complaints

no pain

highly

symptomatic

set up error

1 mm

3 mm

5mm