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How do you approach treatment for a patient who develops a nodal recurrence years after primary resection of NSCLC?

Is there data to guide treatment re: SBRT vs. concurrent chemoradiation vs. sequential therapy vs. systemic therapy alone? Does the nodal location impact your decision?
2 Answers
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Radiation Oncology · Florida International University
Answered on

I agree with @Dr. First Last's approach re mediastinal relapse; we consider delayed limited nodal relapse as a manifestation of microscopic disease that has had the opportunity to manifest itself, and the implication would be that this was Stage III disease to begin with, and our salvage strategy th...

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Radiation Oncology · City of Hope
Answered on

I assume that when you say nodal recurrence, you are referring to mediastinal nodal recurrence. In these situations, whether it is after surgery or SBRT to the primary, I would treat this patient as a de novo or recurrent stage III patient. If the patient is medically fit, then neoadjuvant therapy (...

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