In patients receiving concurrent chemoRT for lung cancer, do you have thresholds for cytopenia at which you would hold RT?

Before the cell recovery stuff, which is now falling out of favor I hear, my constraints for holding RT in these types of cases were:

* Platelets 20K or less: spontaneous bleeding can occur at this point or lower.

* Absolute Neutrophil count (ANC) of 0.5 or less.

I know some folks have an ANC cut-of...

So, back in the day, before the cell stimulating commercial chemicals, and less toxic chemo agents used today / modern supportive measures, we treated with bigger ports (more scatter to adjacent stuff) -> lower energy beams and larger RT ports. For example, cases like Anal / Uterine / Cervix / Recta...

I would suggest that the most important element of changing therapy in the case of low counts is to identify the cause of the low counts. It's hard to imagine how limited stage focal XRT would make a dramatic impact on counts. Looking at the extreme case of large volume marrow irradiation (other tha...

I hold for ANC < 1 if there is significant mucosa in the field, because I find that these patients have dramatically worse mucositis. Fortunately, I rarely see this now.