How would you manage a centrally located new primary squamous NSCLC after prior definitive chemoradiation to 45 Gy/30 fractions for small cell lung carcinoma?

The patient in question developed this new primary 3 years after prior chemoradiation. What dose constraints would you apply if treating with reirradiation?

Answer from: Radiation Oncologist at Academic Institution

If it is localized disease with good KPS and there is no option of surgical resection, I would consider definitive chemo/RT to 60 Gy in 30 FX. I would keep the cumulative dose to the esophagus under 100 Gy, bronchial tree under 110 Gy, and major vessels under 120 Gy.

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Radiation Oncologist at Beaumont Health System
I agree with @Joe Y. Chang. You could also conside...

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How would you manage a centrally located new primary squamous NSCLC after prior definitive chemoradiation to 45 Gy/30 fractions for small cell lung carcinoma?

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