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Radiation Oncology • Thoracic Malignancies
How would you manage de novo oligometastatic NSCLC with an isolated low cervical node metastasis?
If there is partial response after chemoimmunotherapy in the primary, would you consolidate the primary? If there is complete response in the metastatic node, would you still consider treating the nodal region?
Answer from: Radiation Oncologist at Academic Institution
I view the presence of an isolated low cervical node as somewhere in between an advanced stage III (since supraclavicular/scalene is N3), and oligometastatic stage IV. In either case, assuming the patient received several cycles of induction systemic therapy without progression, I do believe there i...
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Answer from: Radiation Oncologist at Academic Institution
I broadly agree with Dr. @Michael Xiang's comment. I think that the SC area is one of the more-challenging places for us to rely heavily on imaging, since:
It is challenging to see the tumor and nerves both the time of planning and during IGRT;
PET images are often not done in the tx position, so ...
Comments
Radiation Oncologist at University of Texas at Tyler
If the primary site is controlled, then what about...
If the primary site is controlled, then what about...
Radiation Oncologist at UNC School of Medicine
Surgery in this area is almost always not a "cance...
Surgery in this area is almost always not a "cance...
Radiation Oncologist at University of Texas at Tyler
Thank you.
Thank you.