How do you treat Stage IIIC T4N3 NSCLC?   

Probably need a bit more information since T4 is fairly heterogeneous, but it is absolutely treatable. If it involves both ipsilateral lobes, then SBRT to one isolated lesion and CRT for the rest is one approach. If T4 is involved in critical mediastinal organs, probably some induction therapy with ...

The PACIFIC study utilized Version 7 of the International Association for the Study of Lung Cancer Staging Manual, where stage IIIC lung cancer did not exist. I suspect some study participants had T4N3M0 disease.

As Dr. @Ohri has pointed out, T4N3 in the new staging system would have included patients eligible for the PACIFIC approach, which would be the current "standard of care" for most of these patients. In those with very bulky disease where the radiation fields might be "too formidable" due to tumor vo...

For larger tumors at high risk for local progression, I've begun treating the primary with an SBRT boost x2 a week before starting the six weeks of CRT. The benefits include increased tumor cell killing + wiping out exhausted lymphocytes and myeloid cells to allow for more active immune cell recruit...