Stereotactic Ablative Radiotherapy for Centrally Located Early Stage Non–Small-Cell Lung Cancer: What We Have Learned Joe Y. Chang, MD, PhD, Andrea Bezjak,

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Presentation transcript:

Stereotactic Ablative Radiotherapy for Centrally Located Early Stage Non–Small-Cell Lung Cancer: What We Have Learned Joe Y. Chang, MD, PhD, Andrea Bezjak, MD, Françoise Mornex Journal of Thoracic Oncology Volume 10, Issue 4, Pages 577-585 (April 2015) DOI: 10.1097/JTO.0000000000000453 Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 1 Recommended definition of central lesion: a tumor within 2 cm in all directions of any mediastinal critical structure, including the bronchial tree, esophagus, heart, brachial plexus, major vessels, spinal cord, phrenic nerve, and recurrent laryngeal nerve. Journal of Thoracic Oncology 2015 10, 577-585DOI: (10.1097/JTO.0000000000000453) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 2 Treatment plans and dose-volume histograms illustrate differences in doses to the mean PTV when doses are prescribed (Rx) to the 60%, 80%, and 100% isodose lines. PTV, planning target volume. Journal of Thoracic Oncology 2015 10, 577-585DOI: (10.1097/JTO.0000000000000453) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions

FIGURE 3 Beam-angle-optimized SABR plans for delivering 50 Gy in four fractions while keeping target coverage and avoiding overdoses to nearby critical structures for tumors in four locations: near the brachial plexus (A); near the major vessels (B); near the bronchial tree, esophagus and spinal cord (C); and near the esophagus and heart (D). Color wash dose distributions are shown with corresponding scales. The gray area inside the high-dose region indicates where the dose was higher than the scale maximum (6238 cGy). BP, brachial plexus; PV, pulmonary vessel; BT, bronchial tree; E, esophagus; SC, spinal cord; A, aorta; H, heart; GTV, gross tumor volume; SABR, stereotactic ablative radiotherapy. Journal of Thoracic Oncology 2015 10, 577-585DOI: (10.1097/JTO.0000000000000453) Copyright © 2015 International Association for the Study of Lung Cancer Terms and Conditions