For a patient with locally advanced lung cancer and mediastinal but not hilar involvement, would you electively treat the ipsilateral hilum?
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For a patient with locally advanced lung cancer and mediastinal but not hilar involvement, would you electively treat the ipsilateral hilum?
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2 Answers
Mednet MemberInvited Expert
Radiation Oncology · UCLA | VA Greater Los Angeles Healthcare System
Answered on
As Dr. @Dr. First Last eludes, the lymphatic drainage pattern justifies buzzing the hilar basin. It's unclear if we need to prescribe a full (60 Gy) or microscopic dose (45-50 Gy). The hilar region often receives an incidental microscopic dose anyway due to dose spillage from the 60 Gy targets. But,...
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Mednet Member
Radiation Oncology · Michigan Healthcare Professionals, PC
Answered on
Logically, it would make sense to include elective regions such as the ipsilateral hilum or adjacent uninvolved LN regions. However, most of the new protocols do not include any elective nodal treatment, so I don't think I would - i.e. RTOG 0617 treated solely gross disease. Especially, since we are...
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