How would you manage a recurrent mediastinal node 2 years after 45Gy BID to this region with combined chemotherapy for SCLC in patient no longer tolerating systemic therapy?

If comprehensive restaging (PET, Chest CT with IV contrast, brain MRI) demonstrated a single biopsy proven nodal recurrence 2 years after standard chemo-XRT, I would retreat the patient. The critical structures are likely to be the trachea (tolerance dose ~90Gy) and the esophagus. There has been som...

I agree with Dr Stevens. With nodal relapse in a 45 Gy BID field, late recurrence suggest need for more powerful fraction size and dose. I like 3Gyx15. Similar case with 2 yr relapse bx + at primary. Chemo was started, but either SBRT or hypoFx. just to 4D defined target is my solution to isolated l...