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How do you decide which dose/fractionation to use for consolidative therapy to the lung in patients with oligometastatic NSCLC who have responded well to first-line systemic therapy?

Does the site of oligometastasis matter (ex. brain v bone)? In this trial https://www.ncbi.nlm.nih.gov/pubmed/27789196 20% of patients were treated with SBRT and 56% were treated with intermediate or standard fractionated radiotherapy to the lung (RT details in Appendix Supplementary Table S2).
2 Answers
Mednet Member
Mednet Member
Radiation Oncology · University of Colorado School of Medicine
Answered on

For the first part of the question, I broadly think of two groups of patients

1) Lung nodule suitable for SBRT: would then do something like 54 Gy in 3 or 50 Gy in 5 depending on the location

2) Stage III, ie primary in lung and mediastinal nodes: would then do something like 45 Gy in 15 fractions. ...

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Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · University of Rochester
Answered on

I agree with @Dr. First Last. There really is not a correct answer to this question since it depends on the patient and their disease. The ultimate goal is to offer local control and minimize toxicity risks. This becomes a judgement call- and relying on published data, ongoing protocols and personal...

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