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Radiation Oncology • Thoracic Malignancies
How do you decide which dose/fractionation to use for consolidative therapy to the lung in patients with oligometastatic NSCLC who have responded well to first-line systemic therapy?
Does the site of oligometastasis matter (ex. brain v bone)? In this trial https://www.ncbi.nlm.nih.gov/pubmed/27789196 20% of patients were treated with SBRT and 56% were treated with intermediate or standard fractionated radiotherapy to the lung (RT details in Appendix Supplementary Table S2).
Answer from: Radiation Oncologist at Academic Institution
For the first part of the question, I broadly think of two groups of patients
1) Lung nodule suitable for SBRT: would then do something like 54 Gy in 3 or 50 Gy in 5 depending on the location
2) Stage III, ie primary in lung and mediastinal nodes: would then do something like 45 Gy in 15 fractions...
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Answer from: Radiation Oncologist at Academic Institution
I agree with @Laurie E. Gaspar. There really is not a correct answer to this question since it depends on the patient and their disease. The ultimate goal is to offer local control and minimize toxicity risks. This becomes a judgement call- and relying on published data, ongoing protocols and person...