Mednet Logo

Do you recommend adjustment of lung dose constraints in the setting of stage III lung cancer treated with definitive concurrent chemoradiation followed by planned consolidation immunotherapy?

Community PollStarted

Do you use more stringent lung dose constraints for patients with stage III NSCLC who will receive consolidation immunotherapy?

75 physicians have voted

Join Mednetto vote and see how they answered.

3 Answers
Mednet Member
Mednet Member
Radiation Oncology · University of Colorado School of Medicine
Answered on

No, the normal tissue constraints have not changed now that adjuvant durvalumab is the new standard of care. Of course we should always be trying to make our normal tissue dose constraints as low as possible, without underdosing the target. And we should probably assume that all patients are going t...

Join for free or sign in to see the full answer

Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Washington University School of Medicine
Answered on

We are reviewing our internal results on the first cohort of patients to make it through 1 year of consolidation Durva in clinical practice to determine whether rates of pneumonitis are higher, and if so, whether dose adjustment is reasonable. We will also explore whether lower dose metrics (such as...

Join for free or sign in to see the full answer

Mednet Member
Mednet Member
Radiation Oncology · Retired
Answered on · Updated on

Soon, all lung constraints for lung cancer radiotherapy will have to presume immunotherapy. In May 2019, probably the vast majority of our patients get started on it following thoracic radiotherapy.

Also, it does get personal. I have a lady who finished 5940 cGy in 33 fractions for Stage IIIA Adenoca...

Join for free or sign in to see the full answer