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How do you treat a radioresistant (e.g. RCC or melanoma) oligometastases in a weight-bearing bone after surgical resection and stabilization?
If surgical stabilization has been performed, do you go with SBRT dosing? If so, do you treat only the involved site and not the extent of hardware? Does your recommendation change if it is an incomplete resection?
Answer from: Radiation Oncologist at Academic Institution
Let's assume we are dealing with a femoral met. If the surgeon just puts an intramedullary (IM) nail through the tumor (tumor not resected), the whole length of the nail will have to be treated as it carries the tumor cells with it as it goes down through the medullary canal. In this situation,...
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