PMC6699306_01
SBRT plan for Patient 1 showing conformal radiation dose delivery to the right pulmonary mass.
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fig1
Therefore, she was treated with a total of 50Gy in 5 fractions of SBRT using two co-planar arcs (Figure 1).
DVH showing total lung minus target dose for patient 1.
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The Dose-Volume Histogram (DVH) for the treatment plan showed total lung minus target dose within accepted guidelines (Figure 2).
A chest X-ray showing the development of lung infiltrates in and around the treated right lung mass occurring one month following completion of SBRT.
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A chest x-ray at that time revealed a new right upper lung infiltrate at the treated site (Figure 3).
A chest X-ray, taken 5 days after the chest X-ray depicted in Figure 3, revealing rapid progression of lung infiltrates in multiple lobes.
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A chest x-ray now revealed bilateral pulmonary infiltrates (Figure 4).
CT scan images above the plane, thru the plane, and below the plane of SBRT treatment showing diffuse infiltrates ((a), (b), and (c) images respectively).
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A CT scan of the chest revealed diffuse bilateral pulmonary infiltrates in all lobes of both lungs (Figure 5).
PMC6699306_02
SBRT plan for Patient 2 showing conformal radiation dose delivery to the left pulmonary mass.
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fig6
Consequently, he received a total dose of 50Gy in 5 fractions using SBRT thru two coplanar arcs (Figure 6). This gentleman is alive 18 months later after his initial presentation with dyspnea and the images taken in Figure 6.
DVH showing total lung minus target dose for patient 2.
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The Dose-Volume Histogram (DVH) for the treatment plan showed total lung minus target dose within accepted guidelines (Figure 7).
CT images above and at the plane of SBRT treatment showing lung infiltrates and dense consolidation in the left lower lung ((a) and (b) images respectively).
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A CT scan of the chest was performed that revealed volume loss in both lungs with coarse subpleural interstitial changes in the upper and lower lobes (Figure 8).
CT images 3 months after the initial presentation of pneumonitis. Images are at approximately the same level as those shown in Figure 6. There has been considerable clearing of the infiltrates and dense consolidation.
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A CT scan of the chest performed 3 months after his hospitalization revealed no evidence to suggest progression of cancer (Figure 9).