Topics:
Lung Cancer • Radiation Oncology • Thoracic Malignancies • Stereotactic Body Radiotherapy • Non-small cell lung cancer
Is surgery preferable over SBRT for peripheral NSCLC invading into ribs?
Is local control worse for SBRT when the tumor is invading into the bone (rib)?
Answer from: Radiation Oncologist at Academic Institution
There is not much data about SBRT in tumor invading the rib. Technically, this is T3 disease. There are three uncertainties: 1. Chest wall toxicity. 2. Tumor contour and margin. 3. Optimal dose. Since surgical resection remains the standard care for operable disease, withou...
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Answer from: Radiation Oncologist at Academic Institution
Agree with @Joe Y. Chang that the data for T3N0 and SBRT is really murky. In an operable patient I too would favor surgery.
If the tumor is very inflitrative into the chest wall I'd do induction chemo/xrt (50-60Gy with weekly carboplatin/taxol) to try to limit the extent of chest wal...
Answer from: Radiation Oncologist at Academic Institution
I agree with @Joe Y. Chang's answer - if operable then resection offers the least compromised approach in terms of oncological outcome.If high risk for resection or medically inoperable the decision becomes more complicated. ChemoRT, conventional RT, hyporfactionated RT, and SBRT are all reasonable ...
Answer from: Radiation Oncologist at Community Practice
There should be an option for concurrent chemo-radiation IMO. I'd take it to 70 with carbo/taxol, assuming the patient is not a surgical candidate.
Comments
Radiation Oncologist at Radiation Medicine Associates
I’ve been doing concurrent using Bogart’s 70 G...
I’ve been doing concurrent using Bogart’s 70 G...