How does your management of locally advanced NSCLC change in a patient with a previous contralateral pneumonectomy?
For a patient with a new contralateral primary or recurrence and previous pneumonectomy, what lung constraints do you prioritize (ex mean lung dose, V20)? Would concurrent chemoradiation therapy to 60Gy still be standard of care or is sequential therapy preferred to potentially decrease your treatment field?
Answer from: Radiation Oncologist at Academic Institution
I've tried to tackle this a few times in my practice and it's uber hard. Depending on the size, it's often impossible. You are really stuck with the constraints for Mesothelioma in the setting of EPP. That is V20 of 7% and MLD of 8.5 Gy (Int. J. Radiation Oncology Biol. Phys., Vol. 69, No. 2, pp....
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