What radiation dose is appropriate for patients receiving induction chemoradiation prior to surgery for superior sulcus tumors?
RTOG 0229 demonstrated the safety and efficacy of increasing the radiation dose to 61.2 Gy in the trimodality setting. Therefore, current standard concurrent chemoradiation therapy uses 61.2 Gy, which is safe with or without surgical resection, with improved mediastinal nodal clearance rate (63%). 4...
I peronally take advantage of these cases to directly engage the thoracic surgeon who's planning to do the resection. I agree with Charles that 45 Gy may be too low, and prefer to Rx at least 50 Gy. By getting the surgeon to help contour, we can illustrate how our doses can be painted with SIB techn...
While the cooperative group data suggest that 45 Gy is reasonable for potentially resectable dx; I prefer to treat to higher doses with hopes of increasing the pCR.
Alternately, it is not unreasonable to consider induction platinum-based combination chemotherapy followed by re-staging and then chemor...