| UHW | UPMC | UofT | UVAMC | RSMC |
---|---|---|---|---|---|
Use of single fraction radiosurgery | No, all patients are treated with either five or ten fractions | Single fraction radiosurgery for 95% of the patients unless very near to spinal cord. | Majority is treated with two or three fractions and specific cases for single fraction | Majority is treated with a single fraction of radiosurgery, occasionally up to 3 fractions | No, majority are treated with three fractions with treatments given one week apart. |
Criteria for selection of hypo-fractionated regimes | Selection of fractionation scheme based on life expectancy using the Mizumoto Score | Â | Fractionated protocols in: 1. Epidural disease or large volume and no prior irradiation 2. Prior radiation | Fractionated protocols after prior radiation | If it represents the only site of disease, we use 30 Gy in 3 |
Schema 1: # fractions and single fraction dose | Good life expectancy: 30 Gy in 10: PTV-elective 48.5 Gy in 10: PTV -macroscopic * | 16-24 Gy in 1; Most frequently 17 Gy in 1 | 20-24 Gy in 1; Most frequently 20 Gy in 1 | 18 to 24 Gy in 1; Most frequently 20 Gy in 1 | 24 Gy in 3 |
Schema 2: # fractions and single fraction dose | Intermediate life expectancy: 20 Gy in 5: PTV-elective 35 Gy in 5: PTV -macroscopic * | Â | 24 - 27 Gy in 2-3 | 24 Gy in 3 | 30 Gy in 3 |
Schema 3: # fractions and single fraction dose | Â | Â | 30 Gy in 3 (for sarcomas) | 18 Gy in 3 | Â |
Dose prescription | D90 | D90 | ICRU point | D90 | D90 |