For biopsy proven extranodal marginal zone lymphoma involving two small bilateral lung nodules, would you consider definitive treatment to both nodules with radiation therapy?

It has been observed that many patients treated with radiation therapy for an extranodal MZL in a paired organ (orbital and parotid, in particular) will develop metachronous disease recurrence in the contralateral organ (Goda et al., PMID 20564130). In fact, it is relatively common for patients with...

As is often the case with questions addressed to theMednet, one would like to know a little more about the patient before making a definitive recommendation, age, symptoms, general medical condition, etc. Also, the volume of lung that would need to be treated. (Would not rx lymphatics). However, I'l...

Yes, I would. I'd like to use SBRT for this, with a de-escalated dose.

And no, I would not include lymphatics.