Topics:
Radiation Oncology • Thoracic Malignancies
How do you approach local therapy for oligoprogression of metastatic NSCLC?
When patients have a single site of progression while on systemic therapy is it reasonable to consider stereotactic and/or conventional radiation to delay further progression? Does the mutation status (EGFR/ALK) of the tumor affect your treatment reommendations?
Answer from: Radiation Oncologist at Community Practice
Tsai et al. presented data from the CURB trial at ASTRO 2021. This showed a significant improvement in median PFS (44 vs 9 weeks) for NSCLC patients with oligoprogression (unlimited mets at presentation and 5 or less mets on progression) randomized to SBRT vs best supportive care. Interestingly, the...
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Answer from: Radiation Oncologist at Academic Institution
At the University of Colorado, we have very frequently treated such a patient with stereotactic body radiation therapy (SBRT), or hypofractionated or conventional radiation therapy if SBRT is not possible. Unfortunately, there is not as much published literature to support this approach as any of us...