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Radiation Oncology • Thoracic Malignancies
How would you approach an in-field recurrence after lung SBRT for a T1 NSCLC in a patient with poor underlying lung function?
What if the patient is also quite elderly? SBRT was a few years ago.
Answer from: Radiation Oncologist at Academic Institution
Explore non-radiation options, including any molecular testing to seek potential targeted systemic options. Still exhaust alternative local options such as cryoablation or local/wedge resection. Radiation option can still be considered if all other options are exhausted, considering the location (ce...
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Answer from: Radiation Oncologist at Academic Institution
Just to add to this discussion: Upfront repeat SBRT for SBRT failures is appropriate in selected patients. As we were gaining more experience with SBRT, we looked back on our first 500 patients to see how we had managed post-SBRT failures that were local only and published a small series [22 patient...
Comments
Radiation Oncologist at Quillen VA Medical Center
It’s not rare. We almost always biopsy, ther...
It’s not rare. We almost always biopsy, ther...
Radiation Oncologist at UCLA | VA Greater Los Angeles Healthcare System
The Cleveland Clinic series appears to report a 2....
The Cleveland Clinic series appears to report a 2....
Answer from: Radiation Oncologist at Academic Institution
At UCLA, we offer percutaneous HDR brachytherapy for these patients. Wu et al., Journal of Contemporary Brachytherapy 2024
Answer from: Radiation Oncologist at Academic Institution
Honestly, I have not seen such local recurrence after radical SBRT. I would do a biopsy to confirm and do a PET scan to complete the staging work-up.