Physics Bucharest 2017

Adaptive Strategies-Lung cancer

Lung cancer irradiation, the problems numerous! • At planning • Boost volume based on functional imaging • Breathing influences sub-volumes differently • Upper vs. lower lobe tumours

• Tumours vs. lymph nodes • Target vs. OAR (spinal cord)

• Online imaging and matching • Bone vs. soft tissue/tumour • Interfraction variations

• Atelectasis (and lung density changes) • Tumour shrinkage • Pleural effusion