What is the optimal management of patients with stage II lung cancer without nodal metastasis, but unresectable due to poor pulmonary reserve?

For T2bN0 or T3N0 disease, you consider radiation alone, sequential radiation followed by chemotherapy, or concurrent chemoradiation?

Answer from: Radiation Oncologist at Academic Institution

This population of stage II patients without nodal involvement would include T2bN0 (stage IIA) or T3N0 (stage IIB) disease. NCCN 2020 lists either CRT or hypofractionated RT/SBRT as acceptable options. In my experience, if these patients are nonsurgical, then they typically also have multiple c...

Comments

Radiation Oncologist at Washington University School of Medicine
I agree with Dr. @Michael Farris's thoughtful sugg...

Medical Oncologist at The Christ Hospital Network
Our radiation oncologist pushes for more proton th...

Radiation Oncologist at Vanderbilt-Ingram Cancer Center
Can somebody link data suggesting lower incidence ...

Radiation Oncologist at University of Cincinnati Cancer Center
@Rafiullah Khan, this has not been my practice her...

Answer from: Medical Oncologist at Community Practice

Would like more clarity on how nodal status was assessed, location of tumor and clinical TNM staging. If stage IIB, we can consider chemoradiation (ideally concurrent) followed by maintenance immunotherapy, extrapolating data from PACIFIC trial for stage unresectable stage III. If IIA, there is data...

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What is the optimal management of patients with stage II lung cancer without nodal metastasis, but unresectable due to poor pulmonary reserve?

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