Dia 1

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