What is the optimal management of patients with stage II lung cancer without nodal metastasis, but unresectable due to poor pulmonary reserve?

For T2bN0 or T3N0 disease, you consider radiation alone, sequential radiation followed by chemotherapy, or concurrent chemoradiation?

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How do you approach patients with stage II lung cancer without nodal metastasis who are unresectable?

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2 Answers

Mednet Member

Radiation Oncology · Wake Forest School of Medicine

Answered on

This population of stage II patients without nodal involvement would include T2bN0 (stage IIA) or T3N0 (stage IIB) disease.

NCCN 2020 lists either CRT or hypofractionated RT/SBRT as acceptable options. In my experience, if these patients are nonsurgical, then they typically also have multiple co-mor...

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Mednet MemberInvited Expert

Medical Oncology · Donald and Barbara Zucker School of Medicine at Hofstra/Northwell

Answered on

Would like more clarity on how nodal status was assessed, location of tumor and clinical TNM staging. If stage IIB, we can consider chemoradiation (ideally concurrent) followed by maintenance immunotherapy, extrapolating data from PACIFIC trial for stage unresectable stage III. If IIA, there is data...

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