What is the optimal treatment of medically inoperable T3N0 non-small cell lung cancer that is too large for standard SBRT?

As we see it, there is more than one way to skin the cat. RTOG 0617 has condemned protracted fractions to 70 Gy...it just might be that 70 Gy is the wrong way to treat in 35 fractions, +/- cetuximab added to weakly carbo taxol. But the study to look at thoracic dose is contaminated by those systemic...

update on 2/26/24:

I have been asked whether I have any updates to my comments of some years ago regarding the issue of SBRT for large inoperable T3N0 lung cancers. We have not changed our practice with respect to the SBRT component of our decision-making since as I noted, we have published on the ap...

Please read the preceding responses first as they are excellent. I wanted to add that there are 2 prospectively evaluated dose regimens that must be noted, particularly for patients going radiation alone without SABR.

The NCIC BR.25 treated patients to 60 Gy in 15 fx dose to isocenter with local cont...

Based on guidelines, the current standard for T3N0, IIB inoperable lung is probably chemoRT 60-66 Gy. I would not suggest going beyond 66 Gy as RTOG 0617 comparing 60 vs. 74 Gy for stage III disease showed inferior survival in the 74 Gy arm. In a fit patient, concurrent chemotherapy makes sense for ...