Topics:
Radiation Oncology • Thoracic Malignancies
How would you approach a stage III NSCLC that is a biopsy-proven new primary located in the same field as a prior stage III NSCLC previously treated with chemoRT?
Prior tumor was adenocarcinoma, new primary is squamous cell carcinoma.
If you would offer reirradiation, what dose constraints would you apply to the bronchi and esophagus?
Answer from: Radiation Oncologist at Academic Institution
First, I'd need to know the interval since the previous course of radiation. If it was recent, this may simply be the growth of a resistant subclone. Next Gen sequence comparison can be helpful here.
If the interval was >3 y, it may well be a new cancer. I would give the patient the benefit of t...
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Answer from: Radiation Oncologist at Academic Institution
If >1 year since conventional fractionation, presumably to 60-70 Gy, I would feel comfortable repeating full dose chemoradiation with IMRT/IGRT and I would not compromise tumor coverage in an attempt to satisfy plan sum based constraints which would most likely result in a palliative treatment on...