Is there any role for adjuvant radiotherapy for resected multistation N2 atypical carcinoid tumor of the lung?

Carcinoid tumors, whether typical or atypical, are not very responsive to radiotherapy. Adding the feature of “multi-level N2 nodes”, the prospect of local and systemic recurrence increases. So, to many, this bolsters the logic to offer thoracic radiotherapy. These tumors are also not very responsive to chemotherapy, and despite similarity to small cell under the microscope, they do not respond or metastasize in the same manner (forget PCI too).

I would present to the multidisciplinary board and express no inclination to use the beam prophylactically to either thorax or brain. Reserve for palliation at recurrence.