Would you offer RT for a nodal recurrence of NSCLC that has resolved radiographically after chemotherapy?

Topics: Radiation Oncology • Thoracic Malignancies

If so, what dose and what would you include in your field? Would the pre-chemotherapy extent/burden of nodal recurrence influence your decision?

Answer from: Radiation Oncologist at Academic Institution

Nodal recurrences are bad. When addressing nodal disease that "disappears" after chemotherapy, I have modeled my decision making on the premise used in small cell lung cancer treatment where even in the face of CRs on imaging after chemotherapy, radiotherapy was always added to the mediastinal (noda...

Comments

Radiation Oncologist at Sparks Regional Medical Center
Terrific and thanks!!!!! Great and clear. ...

Answer from: Radiation Oncologist at Community Practice

If treating regional nodal recurrence of NSCLC (e.g., after surgery) with no prior radiotherapy, I would extrapolate from LA-NSCLC trials and recommend upfront concurrent chemoradiotherapy rather than sequential chemoradiotherapy. I would also extrapolate from PACIFIC and consider adjuvant durvaluma...

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