Greater use of IGRT?

[radoncolous]

Hi all,

What is the reason that IGRT is not employed more often for soft-tissue tumours? Reasons I can think of are extra cost/time and lack of evidence that it is really necessary for more routine RT plans. Am I right or is there more to it?

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[medgator]

It is used for those. Igrt can mean lots of things including cone beam CT, which is excellent for that situation

 

[Gfunk6]

Also keep in mind that a significant percentage of sarcomas that we treat are extremity cancers. If you are treating an arm or a leg with reliable immobilization, then electronic portal imaging is adequate. I would certainly not subject a patient like that to daily cone-beam CTs due to unnecessary repeated radiation exposure.

 

[radoncolous]

Thanks for the insight, Gfunk. That makes sense.

Medgator, does that mean you differ and think regular CBCT can be appropriate for such cases?

 

[medgator]

Thanks for the insight, Gfunk. That makes sense.

Medgator, does that mean you differ and think regular CBCT can be appropriate for such cases?

I didn't realize you were talking about soft tissue sarcoma. In pelvic and lung soft tissues, cbct can be very helpful.

In extremity soft tissue sarcoma, I agree with gfunk that simple portal imaging or maybe daily orthogonal igrt is enough and I wouldn't do cbct in that situation

 

[Neuronix]

I do know some faculty who use CBCTs for extremity STS. You can argue about weekly or daily. Part of the issue is immobilization and how well you trust the reproducibility of the setup. Arms and legs rotate a lot, and rotation can be hard to see on plain films.

 

[radoncolous]

Interesting. Thanks for the insight!