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Would you offer empiric lung SBRT for two growing FDG-avid lung lesions in a patient with severe COPD on oxygen?

Is there a numerical limit to the number of lesions you would treat empirically without pathology?
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What is the maximum number of lung lesions you have treated empirically with SBRT in a single course?

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2 Answers
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Radiation Oncology · Fox Chase Cancer Center
Answered on

This is a good question! The short answer is yes, most likely. Many patients are too high-risk to receive biopsies; this is decided by surgery/pulm/IR. Unless the patient has contraindications to RT or something like severe IPF (where treatment may be worse than the disease), I would likely offer th...

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Mednet Member
Mednet Member
Radiation Oncology · Baylor Scott & White Health
Answered on

Yes. Recommend tissue-free MRD testing first as a baseline (methylation-based tumor fraction), and it reflexes automatically to liquid biopsy as well if positive. I don't think I can say which brand here, but it is well-known.

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