PCI and WBRT for SCLC

[firewicket]

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Question for the group. Do you purposefully extend the PCI field/WBRT field for brain mets in SCLC to include the posterior orbits (almost like a CNS lymphoma). Or do you treat like a normal whole brain.

 

[OliveTree]

Question for the group. Do you purposefully extend the PCI field/WBRT field for brain mets in SCLC to include the posterior orbits (almost like a CNS lymphoma). Or do you treat like a normal whole brain.

Normal whole brain fields

 

[Gfunk6]

Same here


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[Palex80]

Normal whole brain.

Interestingly I cannot recall seeing a patient with SCLC and meningeosis carcinomatosa. I have seen it often in NSCLC (adeno) but not in SCLC.

 

[seper]

also orbital or ocular mets with SCLC are not very common

 

[scarbrtj]

I know you didn't say "choroid" but that's what I thought of. The choroid as a metatstatic disease site is rare. Most are actually breast cancers. Second most common is lung; and NSCLC is more to blame out of proportion to its incidence versus SCLC. So theoretically if you think of posterior eye coverage for SCLC PCI you'd need to think of it for NSCLC WBRT for NSCLC brain mets (and of course we don't). We all know the "sanctuary" status for the eye in CNS lymphoma. No one has reported that I don't believe for SCLC.

https://moffitt.org/File Library/Ma...ials/Cancer Control Journal/v5n4/article4.pdf
https://www.ncbi.nlm.nih.gov/pubmed/22732948

 

[Cancerdancer]

NRG CC-003 analyzing hippocampal avoidance for SCLC limits the CTV to the brain parenchyma, for what that's worth

 

[RadOncDoc21]

NRG CC-003 analyzing hippocampal avoidance for SCLC limits the CTV to the brain parenchyma, for what that's worth

Wow, really!? Next we will be sparing the hippocampus for GBM's.

 

[seper]

It's a race with insurance companies that NRG will never win 🙂

 

[medgator]

It's a race with insurance companies that NRG will never win 🙂

It won for stage III nsclc.... I don't get as many requests for an awful 3D plan to compare my imrt plan with

 

[nkmiami]

Wow, really!? Next we will be sparing the hippocampus for GBM's.

actually, some people think the gbm starts out in the subvenrticular zone or possibly hippocampus where supposedly the stem cells reside