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Should we consider radiation therapy for patients with N2 EGFRm NSCLC who will receive osimertinib, though RT was excluded on ADAURA?

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4 Answers

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Medical Oncology · University of Maryland

For an EGFR-mutant N2 disease, we favor adjuvant chemotherapy (OS benefit) and/or adjuvant TKI based on ADAURA trial (DFS survival). The only prospective data regarding the use of adjuvant radiotherapy comes from a phase III trial, Lung Adjuvant Radiotherapy Trial (Lung-ART), where patients were ran...

How do you approach adjuvant therapy for resected lung adenocarcinoma that was found unexpectedly postop to be N2?

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10 Answers

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Radiation Oncology · Duke University Medical Center

Preliminary results of the phase 3 randomized LungART trial (NCT00410683) were recently presented at a virtual ESMO conference. 501 patients with pathologically confirmed N2 NSCLC s/p complete resection were randomized to postoperative RT (54 Gy) or observation. Almost all patients received chemothe...

What would your management approach be for a patient with high grade large cell neuroendocrine of the lung, status post resection with negative margins, but visceral pleura invasion noted on path?

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Radiation Oncology · University of Massachusetts Medical School

At present, the role of post-operative radiotherapy (PORT) has been shown, but not definitely proven to be detrimental for patients with resected NSCLC with N0 and N1 involvement by retrospective reviews of the ANITA trial and the SEER database (Lally et al J Clin Oncol 2006; 24:2998-3006), as well ...

Is there a role for post-operative chemoradiation therapy in fully resected, margin-negative T3N1 NSCLC?

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Radiation Oncology · Yale School of Medicine

I assume you're talking about T3 for chest wall invasion, and I think the answer is probably no routine role for RT for this individual risk factor. If you look at surgical series, invasion of the chest wall IS a risk factor for both positive surgical margins, and local recurrence. But if you limit ...