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  • SBRT Spine TX Plan

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    This document summarizes an 85-year-old male patient receiving stereotactic body radiation therapy (SBRT) to treat an oligometastatic prostate cancer lesion in his spine at T4. The patient has a history of smoking, alcohol use, and various medical conditions. The prescription is for 27 Gy in 3 fractions using volumetric modulated arc therapy with a flattening filter free beam. Special immobilization is needed due to targeting the spine. Planning objectives aim for a conformity index of 0.99 while sparing nearby organs-at-risk. Daily set up involves immobilization, shifts if needed based on imaging, and oversight by a physicist.

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    This document summarizes an 85-year-old male patient receiving stereotactic body radiation therapy (SBRT) to treat an oligometastatic prostate cancer lesion in his spine at T4. The patient has a history of smoking, alcohol use, and various medical conditions. The prescription is for 27 Gy in 3 fractions using volumetric modulated arc therapy with a flattening filter free beam. Special immobilization is needed due to targeting the spine. Planning objectives aim for a conformity index of 0.99 while sparing nearby organs-at-risk. Daily set up involves immobilization, shifts if needed based on imaging, and oversight by a physicist.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    58 views22 pages

    SBRT Spine TX Plan

    Uploaded by

    api-542965039
    This document summarizes an 85-year-old male patient receiving stereotactic body radiation therapy (SBRT) to treat an oligometastatic prostate cancer lesion in his spine at T4. The patient has a history of smoking, alcohol use, and various medical conditions. The prescription is for 27 Gy in 3 fractions using volumetric modulated arc therapy with a flattening filter free beam. Special immobilization is needed due to targeting the spine. Planning objectives aim for a conformity index of 0.99 while sparing nearby organs-at-risk. Daily set up involves immobilization, shifts if needed based on imaging, and oversight by a physicist.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 22

    SBRT Spine

    Grace Schiefer
    Diagnosis

    • 85 yr. old male


    • Oligometastatic Adenocarcinoma of the Prostate w/ boney lesion at T4
    • Stage cT1N0M1
    • Gleason 4+4
    • Stereotactic Radiation for Spine Lesion
    • Radiation for Prostate
    • Currently on ADT Hormonal Therapy
    Patient History

    • Former smoker • Medical


    • Cigarettes
    • Basal Cell Carcinoma 2008
    • Osteoarthritis
    • Cigars
    • Anemia
    • No smokeless tobacco • Hyperkalemic
    • Alcohol use • Hypertension
    • Hyperlipidemia
    • Allergies • Surgical
    • Lipitor (atorvastatin) • Cataract removal
    • Skin excision
    • Total knee replacement
    • Heart stent
    • Advantage of SBRT over Standard Fractionation
    Prescription • VMAT 10 MV FFF
    • 27 Gy in 3 Fx
    CT Sim
    Immobilization • Why do we need special immobilization?
    • Structures
    Planning Objectives • Conformity Index 0.99
    • Normalization 98.4%
    Beam Arrangement
    • Typical Arrangement vs Old Arrangement
    • Arc Advantage
    • Arc Disadvantage
    • G181-179 Collimator 90 - 2175 MU - 540.3 cGy
    • G178-182 Collimator 0 - 1448 MU - 359.7 cGy
    • Collimator Angle
    • FFF
    • 6 DOF
    Optimization Process • Spinal cord + 2 mm
    and Structures • Uppers and Lowers
    Spinal Cord

    • Posterior Avoidance
    • Spinal Cord
    • Spinal Cord + 2 mm
    • PTV
    Ring 50%
    Ring 0
    Esophagus
    Isodose Lines
    Sagittal
    Axial
    Coronal
    • PTV Eval • Skin
    • Spinal Cord + 2 • Great Vessels
    DVH • Esophagus • Lungs
    Tolerance Doses
    • AP SSD 90.1 cm • X = 1 cm

    Set Up Fields and DRRs • RL SSD 74.9 cm


    • LL SSD 73.9
    • Y = 5.50 cm
    • Z = 12 cm
    • Immobilization

    Daily Set UP • Daily shifts


    • Imaging
    • Oversite by physicist

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