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Risk adapted fractionation – Clinical Situation

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

13.06.2016

Matthias Guckenberger - ESTRO SBRT Course 2016 Athens

25