Would you consider elective nodal irradiation when treating a solitary mediastinal node recurrence after chemo RT for non- small cell adenocarcinoma?

Rarely do I consider elective nodal irradiation after solitary mediastinal recurrence, especially after previous chemoRT. The morbidity of treating large volumes after previous chemoRT remains significant. After mediastinal relapse, patients still are at the highest risk for distant failure. Therefo...

No. However, I think rigorous staging is essential with PET and ebus. I’d limit my fields accordingly. Usually the addition of margins provides adequate doses to adjacent nodes. The question is really what dose/fractionation to use. If the patient failed conventional fractionation, I try to use larg...