How do you approach treatment for isolated lung recurrences in patients that did not tolerate chemotherapy after lobectomy?

Would a large number of peribronchial nodes but negative nodes at the hilum and mediastinum (LN stations 7-10) affect decision making or volumes? What dose is appropriate? Does involvement of the chest wall and ribs affect your decisions about treatment?Is IMRT appropriate to limit lung/liver dose if it is along the chest wall?

Answer from: Radiation Oncologist at Academic Institution

For non-small cell lung cancer recurrences after lobectomy I approach them the same way as a newly diagnosed NSCLC. If the lymph nodes are negative and the recurrence is small and away from the hilum and central structures, I would recommend SBRT, 50 Gy in 5 fractions. If the lymph nodes are negati...

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How do you approach treatment for isolated lung recurrences in patients that did not tolerate chemotherapy after lobectomy?

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