In a patient with a mediastinal recurrence following lobectomy for early stage NSCLC, what would be your treatment volume?

In a patient who develops an isolated failure in a regional nodal site after surgery, I would treat in a manner similar to inoperable stage III NSCLC (concurrent chemotherapy and radiation therapy). Under most circumstances, I would include some "selective" elective nodal coverage based on a number ...

When there is a relapse post surgery, salvage is a long shot. Dealing with post lobectomy versus post pneumonectomy provides different caveats. My/our goal at the University of Michigan dose escalation trial was practical: elective nodes made the target too large to conduct a dose escalation trial. ...