1. Stereotactic radiotherapy for lung oligometastases
- Author
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Falcinelli, L., Menichelli, C., Casamassima, F., Aristei, C., Borghesi, S., Ingrosso, G., Draghini, L., Tagliagambe, A., Badellino, S., and di Monale e Bastia, M. B.
- Subjects
Oligometastasis ,Toxicity ,Oncology ,Local control ,Stereotactic radiotherapy ,Hypofractionation ,Radiology, Nuclear Medicine and imaging ,Bed ,Organ motion ,Radiosurgery ,Lung metastases - Abstract
30-60% of cancer patients develop lung metastases, mostly from primary tumors in the colon-rectum, lung, head and neck area, breast and kidney. Nowadays, stereotactic radiotherapy (SRT ) is considered the ideal modality for treating pulmonary metastases. When lung metastases are suspected, complete disease staging includes a total body computed tomography (CT ) and/or positron emission tomography-computed tomography (PET -CT ) scan. PET -CT has higher specificity and sensitivity than a CT scan when investigating mediastinal lymph nodes, diagnosing a solitary lung lesion and detecting distant metastases. For treatment planning, a multi-detector planning CT scan of the entire chest is usually performed, with or without intravenous contrast media or esophageal lumen opacification, especially when central lesions have to be irradiated. Respiratory management is recommended in lung SRT, taking the breath cycle into account in planning and delivery. For contouring, co-registration and/or matching planning CT and diagnostic images (as provided by contrast enhanced CT or PET-CT ) are useful, particularly for central tumors. Doses and fractionation schedules are heterogeneous, ranging from 33 to 60 Gy in 3-6 fractions. Independently of fractionation schedule, a BED
- Published
- 2022