When is it appropriate to recommend SBRT directed to sites of oligometastasis (ex, single adrenal met) for a patient with extensive stage small cell s/p chemo and PCI?

Topics: Radiation Oncology • Palliation • Thoracic Malignancies • Stereotactic Body Radiotherapy

Answer from: Radiation Oncologist at Community Practice

May I play devil's advocate for one moment? I don't wholly disagree with @Neal E. Dunlap btw, fwiw.1) Some people with SCLC can be cured. It appears that the application of a local therapy in limited stage SCLC increases the chance for long-term DFS (aka "a cure"). Five-year survival was doubled fro...

Comments

Radiation Oncologist at CCare
Thanks for the detailed discussion - out of curios...

Radiation Oncologist at Northeast Alabama Regional Medical Center
Looking at the literature and what's been seen in ...

Radiation Oncologist at University of Colorado School of Medicine
Just to be contrary, I think adrenal metastases ar...

Radiation Oncologist at Geisinger
There is no evidence for such an aggressive approa...

Radiation Oncologist at Northeast Alabama Regional Medical Center
here's some data (admittedly presented with all th...

Answer from: Radiation Oncologist at Academic Institution

Unlike NSCLC, true oligometastatic small cell lung cancer is rare. In fact, I'm not sure if I really believe there is such an entity. This disease entity is basically extrapolated from NSCLC data. Giuliani did a review specifically to determine the effect of consolidative thoracic radiotherapy in...

Answer from: Radiation Oncologist at Academic Institution

1) Based on outcomes from radiation therapy alone studies and limited surgical series, I feel comfortable saying that very few "limited stage" SCLCs are truly localized at presentation since most patients will fail distantly if no chemotherapy is given. Thus we should assum...

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