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How do you approach PORT for T3N0 NSCLC, which had chest wall invasion, now status post lobectomy with a microscopically positive margin?
Dose/fractionation? Concurrent v. sequential chemo? What literature do you use to backup PORT for a positive margin?
Answer from: Radiation Oncologist at Community Practice
PORT should still be offered/considered for R1 resection such as this T3N0 patient. It sounds as if this person, or someone in a similar scenario, would have been served well to have undergone NACT to help achieve R0 prior to surgery. But nonetheless, I would take the following approach (assuming ap...
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Answer from: Radiation Oncologist at Academic Institution
Ends up being a relatively rare patient these days but absolutely I offer PORT to any R1+ patients. Agree with Dr. @Brooks above that in hindsight, some better imaging and neoadjuvant therapy likely would have been a benefit here. Probably a patient that would have seen CM-816 regimen (stage IB-IIIA...
Answer from: Radiation Oncologist at Community Practice
I like 6,120 cGy in 34 fractions with concurrent chemotherapy if the patient has decent KPS otherwise if the patient is frail, consider sequential or RT alone, 4-6 weeks after surgery.I don't know of any literature that supports PORT after R1 resection as this would be a difficult study to power, bu...