What pulmonary dose constraints do you use for patients undergoing lung SBRT for metachronous or recurrent disease after definitive chemoradiation?

Re-irradiation for lung tumor is an area of growing interest. Most of the data is based on retrospective series from single institutions so we don't have a standard to go by. The most important issue is patient selection. The largest risk is pneunonitis. Reported rates from MDACC, MSKCC and Louisvil...

I concur with the above if SBRT is the only option. However, it's instructive to remember that pts with locally advanced NSCLC who may have been technically unresectable are often medically operable at the time of relapse. We recently discussed a 60yo pt who had cT3N2M0 NSCLC, was treated per the wi...

I agree with Dr. Dunlap with a couple of caveats.

1. I don't reirradiate patients with PS 3 or greater. Their likely benefit is small.

2. I also consider the disease free interval. If initial radio surgery failed in a few months (which of course is very rare), the retreatment is not likely to bene...