NSCLCRADIOTHERAPY

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NSCLC-RADIOTHERAPY

• Albairouny hospital
• Dr MARAWI . Z

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RTH for NSCLC at ALBairounyHosp

• Radical
• 2 D
• D/F 1.8- 2 Gy
• DTabout-60 Gy
• machine cobalt

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RTH international

• 3D
• Fit isodose
• Less of side effects
• High dose of radiation
• Sometimes RTH pre-op

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Recomended radiation therapy
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DOSE VOLUME DATA for radiation
pneumonitis
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Contreint biologic1-heart

• Sensible for RTH dependant the dose of ionising
  radiation.
• Hard effect for doses more than 35 Gy.
• Insufisient cardiac for dose more than 50 Gy.
• Dependind dose fractionvolume irradiatedage
  dose total and assosiation of radio-chimio.

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Contreint biologic 2-Poumon sain

• Toxicity of healthy lung depend the same factors
  
• dose fractionation
• DT.
• age
• volume irradiated
• Dose of 40 Gy cause hard fibroses

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Contreint biologic 3-oesophage

• Toxicity dose of 45-60 Gy.
• Dose fraction of 2 Gy is the maximal.
• Dose totale of 50 Gy cause less than 5 of late
  complications
• Chemradiation.

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contouring
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Field set-up
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isodose
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CTV - PTV
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FIED SET UP
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BUILD UP -3D
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Plan and dose
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Recurrence of NSCLC Stage III

• SURGERY
• 20 Local failure
• 10 Local Distant failure
• 70 Distant failure

• RADIOTHERAPY
• 35 Local Failure
• 40 Local Distant Failure
• 25 Distant Failure

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HOW WE CAN CHOOSE THE PATINTS for 3 D TREATMENT

• Hopeness for long survival
• NSCLC without M
• Not bulky disease
• Nsmall adenopathy and not adp susclaviculaire
• Eliminating STG? et ?b
• Fit age

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SMALL CELL LUNG CANCER

• After chemotherapy
• 1.8-2 Gy /fr
• DT 50-60 Gy
• Preferable on 3D treatment
• Indication for limit disease

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PCI in SCLC

• Lower fraction regimens are recommended( 1.8- 2
  Gy)
• 25 Gy in 10 fr
• 36 Gy in 18 fr
• 30 Gy in 15 fr