65 year-old man with extensive-stage small cell lung carcinoma due to multiple pleural nodules now s/p carboplatin/etoposide/atezoliumab x 4 cycles with complete mediastinal and pleural response and residual lung mass.
Technique: IMRT or 3d-conformal RT following systemic chemotherapy.
Dose: 30 Gy in 10 fractions to post-chemotherapy tumor volume as well as hilar and mediastinal nodal stations that were involved pre-chemotherapy (per CREST trial).
Simulation: Supine, alphacradle with arms up. 4D-CT recommended to assess for tumor motion during breathing cycle. The simulation is fused with a pre-chemotherapy PET scan which can be seen using the "select overlay" button.
Case contributed by Fox Chase Cancer Center, Temple University.
Contours per ESTRO ACROP
PCI for extensive stage SCLC:
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