What is your approach for a symptomatic inpatient with locally advanced NSCLC who cannot have a PET?
Would you consider treating the full mediastinum or any mildly enlarged nodes, even contralateral? Do you have a strategy that transitions from a palliative to definite approach once the patient has been full staged? (In this case EBUS was negative but there are enlarged and growing N2 nodes and endobronchial obstruction)
Answer from: Radiation Oncologist at Community Practice
These are tough cases. While we ideally aspire to have full (and congruent) staging information, this is not always possible.There are therefore competing pressures. Factors that favor AP/PA, 3 Gy fractions include 1) the need to initiate treatment rapidly given symptomatic burden and 2) the desire ...
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Answer from: Radiation Oncologist at Academic Institution
I would recommend to TX primary tumor, endobronchial lesions, and enlarged and growing N2 nodes. I will not treat the lymph nodes that are mildly enlarged but have been stable and negative by EBUS. Since it could be a potentially curable disease, I would simulate and plan RT as definitive case and t...