How would you approach an in-field recurrence after lung SBRT for a T1 NSCLC in a patient with poor underlying lung function?

Explore non-radiation options, including any molecular testing to seek potential targeted systemic options. Still exhaust alternative local options such as cryoablation or local/wedge resection. Radiation option can still be considered if all other options are exhausted, considering the location (ce...

Just to add to this discussion: Upfront repeat SBRT for SBRT failures is appropriate in selected patients. As we were gaining more experience with SBRT, we looked back on our first 500 patients to see how we had managed post-SBRT failures that were local only and published a small series [22 patient...

At UCLA, we offer percutaneous HDR brachytherapy for these patients. Wu et al., Journal of Contemporary Brachytherapy 2024

Honestly, I have not seen such local recurrence after radical SBRT. I would do a biopsy to confirm and do a PET scan to complete the staging work-up.