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TomoTherapy for CSI

Discussion in 'Radiation Oncology' started by oldking, May 17, 2014.

  1. oldking

    oldking Senior Member 10+ Year Member

    Nov 6, 2002
    Anybody use tomo for csi?

    If so, what are normal dose constraints (or more specifically ... What should I say during oral boards tomorrow?)
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  3. Gfunk6

    Gfunk6 And to think . . . I hesitated Physician PhD Faculty Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

    Apr 15, 2004
    SF Bay Area
    Unfortunately, I have no idea but good luck with oral boards!!!
  4. Palex80

    Palex80 RAD ON 10+ Year Member

    Dec 17, 2007
    Tomotherapy for CSI is a good technique because it eliminates the problems of field adjustments you have when you using standard 3D-techniques. You dont need several variation of the plan to eliminate potential gaps or overlaps.
    Concerning constraints you should point out that a V5 <60% for both lungs should be respected when using tomotherapy. Furthermore there are potential risks of severy thrombo-&leucopenia associated with the large volume of bone marrow receiving small amounts of dose, which wouldn't receive any dose at all using 3D-techniques (mainly the pelvis).
    Last but not least in young female patients receiving CSI (for example medulloblastoma) breast tissue should also be contoured to avoid excessive dose.
  5. mikedc813

    mikedc813 10+ Year Member

    Mar 15, 2004

    Although the oral boards are over this year, for future reference I wouldn't go into oral boards without knowing how to treat using traditional fields. That being said, I only trained using Tomo for CSI.
  6. medgator

    medgator Senior Member Physician 10+ Year Member

    Sep 20, 2004
    Agreed. Unlike something like imrt for h&n, you pretty much still have use to a conventional setup for any non tomo Linac (and despite accurays desire, tomo is still a niche device imo)
  7. Neuronix

    Neuronix Total nerd Administrator Physician PhD Faculty SDN Advisor 10+ Year Member

    Mar 14, 2002
    the beach
    I like this paper an attending gave me a few days ago. Easy to understand and implement.
  8. oldking

    oldking Senior Member 10+ Year Member

    Nov 6, 2002
    Hope everybody passed since I posted this last year and good luck this week! Just bumping this out of curiosity to see if anybody had any additional opinions, insights, etc
  9. seper

    seper 7+ Year Member

    Dec 22, 2010
    I'm curious whether predicted secondary malignancy risk is higher for tomo CSI vs. traditional PROTON fields.
  10. mpdoc2

    mpdoc2 7+ Year Member

    Apr 2, 2009
    Predicted everything's better with Protons. Reality is unfortunately an entirely other story.

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