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Radiation Oncology • Thoracic Malignancies
Is extranodal extension of pN1 NSCLC an indication to offer PORT?
Is extranodal extension of pN1 node by itself an indication to offer adjuvant radiation if there are no additional risk factors like R1/R2 or pN2? What is the literature to support it?
Answer from: Radiation Oncologist at Community Practice
All PORT analyses that I know show no benefit to XRT in N1 cases, and worse survival in some. The “extension” outside tempts one to alter these facts and treat. I would ask about systemic treatment. I’d reserve XRT for exclusive local relapse. I would offer PORT for + margin or any...
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Answer from: Radiation Oncologist at Community Practice
Dr. @Andrew T. Turrisi (the other Drew) has a valid point. Yet, I would treat this patient with a small-field technique to clean up the cancer cells that were left behind. This is b/c patients with N1 involvement and pathologically proven ENE aren't doomed to have a distant relapse. As such, PO...