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Would you consider a third course of radiation to the same site for late lung cancer in-field recurrence?

Similarly, would SBRT be an option for a small central persistent node? What maximum total BED would you accept before no longer recommending additional radiation assuming the patient has an excellent performance status and has declined chemotherapy?
2 Answers
Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Washington University School of Medicine
Answered on

Here are my thoughts:

  • Where the recurrence is relative to surrounding OARs is critical. For example(s):
    • A peripheral pulmonary nodule near the chest wall and lateral to the central structures, plexus, cord, etc with surrounding fibrosis from prior treatment is a much safer bet for re-re-treatment....

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Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Abramson Cancer Center, University of Pennsylvania
Answered on

There are several important issues to consider before you even considering treating this patient

1. Are you sure it's a recurrence? If PET/CTs are used for follow up, false positives are very common. It is vital to ensure there is nodularity (more likely to be a recurrence). Offering a course of anti...

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