Will you consider definitive concurrent chemoradiation for stage IV lung adenocarcinoma with metastasis limited to an internal mammary lymph node?

Would you offer definitive concurrent chemoRT for stage IV lung adenoca with metastasis limited to an internal mammary node?

• Yes, would use chemoRT up front and then monitor
• Yes, would use chemoRT up front, followed by "adjuvant" ICI
• Yes, but only if stable/responsive disease after a short course of systemic therapy (IO +/- chemo) first
• Only if no progression after an extended period of systemic therapy
• No, generally do not offer chemoRT to stage IV disease even with limited thoracic metastases as distant progression is most common
• Other