Slightly related question....
I ran into issues with evilcore denying spine SBRT for prostate oligiomet.
So I am doing psuedo-SBRT (8 fraction IMRT) as a workaround.
How would you dose this? I normally do 24/2 or 27/3 for spine SBRT.
BED10 very different for ultrahypofractionated regimens, but common theme for SBRT spine 18/1, 24/2, 27/3, 35/5 seems to be a BED3 around 120-130 Gy.
This comes out for about 44 Gy in 8 fractions (5.5 Gy/fraction). BED10 = 68.2, BED3 = 125.
Sound reasonable? I can't find any data for delivering abaltive doses to the spine in the 5-10 fraction range.
From lung, we would be talking about an 8 fraction regimen to 60 Gy, and I would not dose escalate that high in spine without some sort of solid data.
Since evicore basically doesn't approve SBRT for oligiomets, I'm wondering if anybody else has worked around it like this. My understanding is that I can't just do a 3 fraction plan and bill it as IMRT.