What scans do you order for follow-up in locally advanced non-small cell lung cancer patients who have completed definitive radiation with concurrent chemotherapy?

To my knowledge, there are no randomized studies that have examined the role and frequency of surveillance imaging in locally advanced NSCLC treated with chemoradiation. There is an ongoing randomized study looking at two follow up schedules in completely resected NSCLC (PMID 17519819).

NCCN recommends chest CT scan every 6-12 months. But considers more frequent imaging in patients with residual abnormalities after chemoradiation. NCCN does not recommend routine follow up PET/CT or brain MRIs in patients without symptoms.

For stage III NSCLC patients treated with chemoradiation, I order non-contrast chest CTs every 3-4 months for the first 2 years and then every 4-6 months thereafter. I do not routinely order PET/CT scans for follow up. I wil...