Topics:
Radiation Oncology • Thoracic Malignancies
For NSCLC patients who are polymetastatic who then become and remain oligometastatic, is there a role for local ablative RT to the primary and metastatic sites?
If so what dose/fractionation would you use?
Answer from: Radiation Oncologist at Community Practice
I think it's an evolving area. I've had several patients with metastatic NSCLC where all their disease except for a couple of spots resolved on subsequent pet scans, for example. The med oncs ask if we could treat those, and I generally will on the theory that these sites might have a different biol...
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Answer from: Radiation Oncologist at Academic Institution
Remember that the @Gomez trial from MDACC (Gomez et al., PMID 31067138) enrolled patients with 3 or fewer lesions AFTER 3 months of first line systemic therapy - so someone could have 10 disease sites, and if 7 resolved on first line systemic they could still be included - relevant especially f...
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Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System
Correct. Sites of residual visible disease after u...
Correct. Sites of residual visible disease after u...
Answer from: Radiation Oncologist at Academic Institution
Agree with above points. As @Ashwin eluded to, I think Gomez is certainly relevant here as these patients were enrolled post-first line systemic therapy. However, only 36% had better than stable disease response (9 patients in both arms) thus, I think only a handful of patients would qualify as trul...